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  • Ruth G. Payton CNM, MSN, FACNM,

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    • Ruth G. Payton received her nurse-midwifery education from the University of Utah in 1976. Her clinical experience ranges from obstetric nursing in the Phillipines and Alaska to nurse-midwifery in Texas and Washington State. She is retired, but during her 30 years in the Air Force Nurse Corps she served on faculty and as program director for the U.S. Air Force Nurse-Midwifery Education Program.

  • Gardner Roxane MD, MPH,

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    • Roxane Gardner received her medical education from Boston University in 1982 and her master of public health education from Harvard University in 1992. She is the medical director of the nurse-midwifery services and director of the Division of Community Medicine at Beth Israel Hospital in Boston, Massachusetts. She is a member of the adjunct faculty of the Department of Maternal and Child Health at the Boston University School of Public Health.

  • Reynolds Dianne CNM, MSN

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    • Dianne Reynolds received her nurse-midwifery education and master of science degree from the University of California San Francisco/San Diego intercampus graduate studies program in 1986. She has practiced full-scope midwifery and has been involved in nurse-midwifery education in a variety of settings, most recently at the Boston University School of Public Health nurse-midwifery education program and the nurse-midwifery departments at Women and Infants' Hospital in Providence, Rhode Island, and Brigham and Womens Hospital in Boston.

Ruth G. Payton, CNM, MSN, 6479 Lost Holly Road, San Antonio, TX 78240.


This article reviews the physiology and pathophysiology of selected endocrine glands. The common presenting clinical signs and symptoms are reviewed, and the initial laboratory tests that may establish the diagnosis are recommended. Diagnosis and management of hypothyroidism, hyperthyroidism, hyperparathyroidism, hypoparathyroidism, pituitary disorders, diabetes mellitus (types I and II), hypoglycemia, and disorders of the adrenal cortex are discussed. The clinical management of the most commonly encountered endocrine disorders seen in the primary care setting is described, and pharmacologic considerations are underscored.