Diseases of adrenal gland
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The document discusses the anatomy and functions of the adrenal glands. It describes that the adrenal glands are composed of an outer cortex that produces cortisol and other hormones, and an inner medulla that produces epinephrine. Conditions like Cushing's syndrome can result from excess cortisol production and cause symptoms like high blood pressure, weight gain, and bone loss. Other disorders addressed include Conn's syndrome, adrenal insufficiency, and adrenocortical tumors.
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Disease of adrenal gland
This patient has hypokalemia with metabolic alkalosis. The combination of hypokalemia and hypertension suggests hyperaldosteronism, likely primary hyperaldosteronism (Conn syndrome). Aldosterone causes increased sodium reabsorption and potassium secretion in the distal tubule of the kidney, resulting in hypokalemia and metabolic alkalosis. Further workup would include plasma aldosterone and renin levels.
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The document discusses disorders of the adrenal glands, including Cushing's syndrome, Conn's disease, Addison's disease, and adrenal crisis. It describes the anatomy and function of the adrenal glands and hormones produced. For each condition, it covers epidemiology, signs and symptoms, diagnostic tests, management, and outcomes of treatment. Cushing's syndrome results from excessive cortisol and can be caused by a pituitary or adrenal tumor. Addison's disease is an autoimmune disorder requiring lifelong glucocorticoid and mineralocorticoid replacement.
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Adrenal disorders involve deficiencies or excesses of hormones produced by the adrenal glands. Primary adrenal insufficiency, such as Addison's disease, results from damage to the adrenal cortex and insufficient production of cortisol and aldosterone. Symptoms include fatigue, weight loss, and low blood pressure. Treatment involves replacing the deficient hormones through medications. Yoga practices like breathing exercises, stretches, and meditation can help manage stress and symptoms.
Primary hyperaldosteronism
1) Primary hyperaldosteronism, also known as Conn's syndrome, is characterized by excessive secretion of the hormone aldosterone from the adrenal glands, causing increased sodium retention and potassium excretion.
2) It can be caused by an aldosterone-producing adenoma, idiopathic bilateral adrenal hyperplasia, or adrenal carcinoma. Aldosterone-producing adenomas account for 65-70% of cases.
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Primary hyperaldosteronism, also known as Conn's syndrome, is a condition caused by excessive secretion of aldosterone from the adrenal glands, leading to sodium retention, potassium loss, and hypertension. It is usually caused by an aldosterone-producing adenoma or bilateral hyperplasia of the adrenal glands. Symptoms include hypertension, edema, hypokalemia, muscle weakness, and polyuria. It is diagnosed through tests of serum electrolytes, plasma and urinary aldosterone levels, and imaging of the adrenal glands. Treatment involves spironolactone and ACE inhibitors to block aldosterone effects and control blood pressure, or unilateral adrenalectomy for adenoma removal
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Addison's disease and Cushing's syndrome are both adrenal disorders but with opposite causes and manifestations. Addison's disease is caused by adrenal insufficiency leading to low cortisol and aldosterone. Symptoms include fatigue, weight loss, hyperpigmentation and hypotension. Cushing's syndrome is caused by excessive cortisol secretion leading to central obesity, hypertension and hyperglycemia. Diagnosis involves blood and urine tests to measure hormone levels. Treatment of Addison's disease involves hormone replacement therapy while treatment of Cushing's focuses on reducing excess cortisol levels through surgery, radiation or drug therapy.
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Adrenal insufficiency, also known as Addison's disease, is caused by destruction of the adrenal cortex leading to deficiencies in glucocorticoids and mineralocorticoids. It presents with non-specific symptoms like fatigue, weight loss, and low blood pressure. Diagnosis involves low cortisol levels in response to ACTH stimulation and high ACTH levels. Treatment is lifelong glucocorticoid and mineralocorticoid replacement. An adrenal crisis can result from infection or stress and requires immediate high dose glucocorticoid treatment in addition to intravenous fluids and glucose to prevent shock.
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Disease of adrenal gland
This patient has hypokalemia with metabolic alkalosis. The combination of hypokalemia and hypertension suggests hyperaldosteronism, likely primary hyperaldosteronism (Conn syndrome). Aldosterone causes increased sodium reabsorption and potassium secretion in the distal tubule of the kidney, resulting in hypokalemia and metabolic alkalosis. Further workup would include plasma aldosterone and renin levels.
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Adrenal Disorders.ppt
Adrenal disorders involve deficiencies or excesses of hormones produced by the adrenal glands. Primary adrenal insufficiency, such as Addison's disease, results from damage to the adrenal cortex and insufficient production of cortisol and aldosterone. Symptoms include fatigue, weight loss, and low blood pressure. Treatment involves replacing the deficient hormones through medications. Yoga practices like breathing exercises, stretches, and meditation can help manage stress and symptoms.
Primary hyperaldosteronism
1) Primary hyperaldosteronism, also known as Conn's syndrome, is characterized by excessive secretion of the hormone aldosterone from the adrenal glands, causing increased sodium retention and potassium excretion.
2) It can be caused by an aldosterone-producing adenoma, idiopathic bilateral adrenal hyperplasia, or adrenal carcinoma. Aldosterone-producing adenomas account for 65-70% of cases.
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Primary hyperaldosteronism
Primary hyperaldosteronism, also known as Conn's syndrome, is a condition caused by excessive secretion of aldosterone from the adrenal glands, leading to sodium retention, potassium loss, and hypertension. It is usually caused by an aldosterone-producing adenoma or bilateral hyperplasia of the adrenal glands. Symptoms include hypertension, edema, hypokalemia, muscle weakness, and polyuria. It is diagnosed through tests of serum electrolytes, plasma and urinary aldosterone levels, and imaging of the adrenal glands. Treatment involves spironolactone and ACE inhibitors to block aldosterone effects and control blood pressure, or unilateral adrenalectomy for adenoma removal
4. adrenal disorders
Addison's disease and Cushing's syndrome are both adrenal disorders but with opposite causes and manifestations. Addison's disease is caused by adrenal insufficiency leading to low cortisol and aldosterone. Symptoms include fatigue, weight loss, hyperpigmentation and hypotension. Cushing's syndrome is caused by excessive cortisol secretion leading to central obesity, hypertension and hyperglycemia. Diagnosis involves blood and urine tests to measure hormone levels. Treatment of Addison's disease involves hormone replacement therapy while treatment of Cushing's focuses on reducing excess cortisol levels through surgery, radiation or drug therapy.
Adrenal insufficiency
Adrenal insufficiency, also known as Addison's disease, is caused by destruction of the adrenal cortex leading to deficiencies in glucocorticoids and mineralocorticoids. It presents with non-specific symptoms like fatigue, weight loss, and low blood pressure. Diagnosis involves low cortisol levels in response to ACTH stimulation and high ACTH levels. Treatment is lifelong glucocorticoid and mineralocorticoid replacement. An adrenal crisis can result from infection or stress and requires immediate high dose glucocorticoid treatment in addition to intravenous fluids and glucose to prevent shock.
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This document discusses Cushing's syndrome, which results from prolonged exposure to excess glucocorticoids. It can be caused by pituitary or adrenal tumors that overproduce cortisol or ACTH. The main clinical manifestations are central obesity, rounded face, fragile skin that bruises easily, and muscle weakness. Laboratory tests used for diagnosis include midnight cortisol levels, dexamethasone suppression tests, and measurements of ACTH. Treatment involves surgically removing the tumor or adrenal glands. Irradiation may also be used if the tumor cannot be fully removed. Lifelong steroid replacement is needed after adrenal gland removal.
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The two adrenal glands produce three main types of hormones: glucocorticoids, mineralocorticoids, and androgens. Cushing's syndrome occurs when there is excessive production of adrenal cortex hormones due to tumors, medications, or other causes. It leads to increased blood glucose, high blood pressure, weight gain, and other issues. Addison's disease is the opposite condition caused by inadequate adrenal hormone production due to issues like autoimmune destruction. It results in low blood pressure, low blood glucose, increased skin pigmentation, and other problems. Both conditions require lifelong hormone replacement therapy and management of complications like infections and adrenal crises.
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- The document discusses diagnostic testing for Addison's disease including the short synacthen test, causes of the condition, and monitoring and treatment options. It also presents results from synacthen tests at the author's hospital over the past few years.
- Based on the results, a baseline cortisol level greater than 350 nmol/L reliably ruled out adrenal insufficiency in patients, suggesting it could be a useful screening test for primary care physicians.
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The adrenal glands secrete hormones that regulate metabolism, electrolyte balance, and stress response. The medulla secretes epinephrine and norepinephrine, while the cortex secretes steroids such as cortisol and aldosterone. Cortisol secretion follows a diurnal rhythm controlled by the HPA axis. Primary adrenal insufficiency results from failure of the adrenal glands, while secondary is a failure of the HPA axis. Presentation includes fatigue, weight loss, hypotension, and hyperpigmentation. Diagnosis involves short corticotropin stimulation tests. Treatment is with glucocorticoid replacement such as hydrocortisone.
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A condition that occurs from exposure to high cortisol levels for a long time.
Fewer than 1 million cases per year (India)
Treatable by a medical professional
Requires a medical diagnosis
Lab tests or imaging always required
Chronic: can last for years or be lifelong
The most common cause is the use of steroid drugs, but it can also occur from overproduction of cortisol by the adrenal glands.
Signs are a fatty hump between the shoulders, a rounded face and pink or purple stretch marks.
Treatment options include reducing steroid use, surgery, radiation and medication.
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The document discusses several adrenal gland disorders including:
1. Addison's disease, which is caused by inadequate production of hormones by the adrenal glands due to problems with the pituitary gland or autoimmune destruction of the adrenal glands.
2. Cushing's syndrome, which is caused by excessive cortisol production from either benign or cancerous tumors of the adrenal glands or pituitary gland.
3. Pheochromocytoma, a rare tumor of the adrenal medulla that secretes excess catecholamines and causes symptoms like headaches and sweating.
4. Testing of the corticotropin-releasing factor is discussed as a way to diagnose hypothal
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The adrenal glands are located above the kidneys and are divided into an outer cortex and inner medulla. The cortex secretes steroid hormones like cortisol and aldosterone which are regulated by the hypothalamus-pituitary-adrenal axis. The medulla secretes catecholamines which are regulated by the sympathetic nervous system. Diseases can result from hypofunction or hyperfunction of the adrenal cortex and include Addison's disease, Cushing's syndrome, Conn's syndrome and pheochromocytoma. Laboratory tests are used to diagnose the underlying cause and guide treatment options such as hormone replacement or surgery.
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This document discusses Cushing's syndrome, which results from high cortisol levels in the blood. It can be caused by exogenous glucocorticoid use, pituitary tumors, adrenal tumors, or ectopic ACTH-secreting tumors. Signs include central obesity, thin skin, high blood pressure, and bone weakness. Diagnosis involves screening tests like dexamethasone suppression tests and measuring ACTH and cortisol levels. If endogenous, further tests localize the source and guide treatment like surgery, radiation, or medication. The most common causes and their treatment approaches are summarized.
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Disorders of adrenal gland
The two adrenal glands produce three main types of hormones: glucocorticoids, mineralocorticoids, and androgens. Cushing's syndrome occurs when there is excessive production of adrenal cortex hormones due to tumors, medications, or other causes. It leads to increased blood glucose, high blood pressure, weight gain, and other issues. Addison's disease is the opposite condition caused by inadequate adrenal hormone production due to issues like autoimmune destruction. It results in low blood pressure, low blood glucose, increased skin pigmentation, and other problems. Both conditions require lifelong hormone replacement therapy and management of complications like infections and adrenal crises.
Addison’s Disease
- Addison's disease is a condition where the adrenal glands do not produce enough hormones like cortisol. It requires lifelong treatment with hydrocortisone and sometimes fludrocortisone.
- The document discusses diagnostic testing for Addison's disease including the short synacthen test, causes of the condition, and monitoring and treatment options. It also presents results from synacthen tests at the author's hospital over the past few years.
- Based on the results, a baseline cortisol level greater than 350 nmol/L reliably ruled out adrenal insufficiency in patients, suggesting it could be a useful screening test for primary care physicians.
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This document discusses diseases of the adrenal cortex, including hyperadrenalism and hypoadrenalism. It describes three hyperadrenal clinical syndromes caused by excess production of cortisol, mineralocorticoids, or androgens. Cushing syndrome is discussed in depth, outlining its causes such as Cushing disease and ectopic ACTH secretion. Hyperaldosteronism and adrenogenital syndromes are also summarized. Hypoadrenalism includes primary and secondary causes, with Addison disease and acute adrenal crisis covered as examples of primary hypoadrenalism.
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Adrenal insufficiency
The adrenal glands secrete hormones that regulate metabolism, electrolyte balance, and stress response. The medulla secretes epinephrine and norepinephrine, while the cortex secretes steroids such as cortisol and aldosterone. Cortisol secretion follows a diurnal rhythm controlled by the HPA axis. Primary adrenal insufficiency results from failure of the adrenal glands, while secondary is a failure of the HPA axis. Presentation includes fatigue, weight loss, hypotension, and hyperpigmentation. Diagnosis involves short corticotropin stimulation tests. Treatment is with glucocorticoid replacement such as hydrocortisone.
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Addison's disease is a rare condition caused by insufficient production of hormones by the adrenal glands. It results in a decrease in glucocorticoids and mineralocorticoids. Symptoms include chronic fatigue, weight loss, and hyperpigmentation. While current treatment replaces the missing hormones, research aims to regenerate damaged adrenal cortex cells through stem cell stimulation in order to cure the disease.
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The document discusses the parathyroid glands, which regulate calcium and phosphate levels and produce parathyroid hormone (PTH). It describes hyperparathyroidism and hypoparathyroidism, conditions caused by excessive or deficient PTH respectively, and their symptoms, causes, assessments, and treatment including diet modifications and medications. Surgical removal of the parathyroid glands may be required to treat hyperparathyroidism.
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This document discusses adrenal insufficiency and its causes, presentation, diagnosis, and management. It can be primary or secondary. Primary adrenal insufficiency, also known as Addison's disease, is caused by destruction of the adrenal cortex leading to deficiencies in glucocorticoids, mineralocorticoids, and sex steroids. Its hallmark symptoms include fatigue, gastrointestinal issues, hyperpigmentation, and electrolyte abnormalities. Secondary adrenal insufficiency spares mineralocorticoid function and can result from pituitary or hypothalamic disease. Diagnosis involves ACTH and cortisol testing, and treatment is glucocorticoid and mineralocorticoid replacement.
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A condition that occurs from exposure to high cortisol levels for a long time.
Fewer than 1 million cases per year (India)
Treatable by a medical professional
Requires a medical diagnosis
Lab tests or imaging always required
Chronic: can last for years or be lifelong
The most common cause is the use of steroid drugs, but it can also occur from overproduction of cortisol by the adrenal glands.
Signs are a fatty hump between the shoulders, a rounded face and pink or purple stretch marks.
Treatment options include reducing steroid use, surgery, radiation and medication.
1. pitutary disoreder hypo & hper
The document discusses disorders of the pituitary gland, including hypopituitarism and hyperpituitarism. It provides details on the hormones secreted by the pituitary gland and their functions. Hypopituitarism is caused by an underactive pituitary gland and can result in diseases like dwarfism, diabetes insipidus, and Addison's disease. Hyperpituitarism is caused by overproduction of pituitary hormones and can result in conditions like acromegaly and Cushing's disease. The document discusses various pituitary disorders in detail, their causes, symptoms, diagnosis, and treatment options.
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Adrenal gland & Cushing's Disease - Seminar August 2015
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Cushing syndrome can be caused by exogenous corticosteroid use, pituitary or ectopic ACTH secretion (ACTH dependent), or adrenal tumors (ACTH independent). The most common cause is exogenous corticosteroid use. Symptoms include weight gain, easy bruising, hypertension, and hypogonadism in men. Diagnostic tests include 24-hour urine cortisol, low-dose dexamethasone suppression test, and late-night salivary cortisol. Further tests are done to determine if the cause is ACTH dependent or independent in order to guide treatment, which may include surgery, medication, or adrenalectomy.
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The adrenal glands produce important hormones that regulate salt, sugar, and sex functions in the body. The adrenal cortex produces mineralocorticoids like aldosterone which regulate sodium and potassium levels, and glucocorticoids like cortisol which regulate carbohydrate, fat, and protein metabolism. The adrenal medulla produces catecholamines like epinephrine and norepinephrine which trigger the fight or flight response. Diseases can result from too much or too little production of these hormones. Cushing's disease occurs when there is too much cortisol and causes weight gain, high blood pressure, and easy bruising. Conn's syndrome features too much aldosterone and causes high blood pressure and low potassium
Phaeochromocytoma
This document provides an overview of pheochromocytoma, which are rare catecholamine-producing tumors. Key points include:
- Pheochromocytomas arise from sympathetic nervous system and can be sporadic or inherited. Approximately 25% of cases are associated with genetic syndromes.
- Presentation involves classic triad of headaches, palpitations, and sweating along with hypertension. Diagnosis is confirmed through urine and plasma tests and imaging studies.
- Complete surgical removal is the primary treatment, with pre-operative medication to control blood pressure. About 10% of cases are malignant with distant metastases. Some pheochromocytomas are associated with genetic syndromes like VHL, MEN2, and
MRI and CT of ADRENAL GLAND
This document summarizes the anatomy and imaging features of various adrenal gland lesions. It describes the typical appearance of the adrenal glands on CT and MRI. Common adrenal tumors like adenomas, carcinomas, pheochromocytomas, and metastases are discussed. Adenomas often appear lipid-rich on CT and demonstrate signal loss on opposed-phase MRI. Carcinomas usually appear large, inhomogeneous, and demonstrate central necrosis. Pheochromocytomas tend to be large and heterogeneous with areas of necrosis. Neuroblastomas often insinuate around vessels in children. Myelolipomas contain detectable fat. Distinguishing features between tumor types are highlighted.
Endocrine week 4 pt
Adrenal gland disorders occur when the adrenal glands do not function properly and can be caused by problems in the adrenal glands themselves or other regulating glands. Some examples of adrenal disorders discussed in the document include Addison's disease, Cushing's syndrome, congenital adrenal hyperplasia, and pituitary tumors. Treatment for these disorders aims to replace missing hormones and address underlying causes through medications, diet changes, and surgery.
Cushing's syndrome
This document provides information about Cushing's syndrome, including:
- It is caused by prolonged exposure to elevated glucocorticoids which can be endogenous (cortisol) or exogenous (medications).
- Cushing's disease is a type of Cushing's syndrome caused by pituitary ACTH overproduction from a corticotroph adenoma.
- Clinical features include central obesity, muscle wasting, thin skin, easy bruising, metabolic complications, and psychological symptoms.
- Diagnosis involves tests like urine free cortisol, late night salivary cortisol, and dexamethasone suppression tests to evaluate HPA axis function and cortisol levels.
Hyperandrogenism ppt 25.1.2011
The document discusses hyperandrogenism and virilization. It begins by defining androgens and their effects on male characteristics. It then discusses the relationships between hormones and the sources of androgens. Several conditions are covered that can cause hyperandrogenism and virilization including polycystic ovary syndrome (PCOS), Cushing's syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors. The signs, symptoms, causes, and pathophysiology of each condition are described. Laboratory tests and ultrasound are discussed for evaluating patients. Lastly, a case scenario is presented of a woman with irregular periods and potential diagnosis of PCOS is discussed.
Addison’s disease important DR. Aijin.A.Mohan
BRIEF DESCRIPTION ABOUT ADDISONS DISEASE FOR DENTAL AND MEDICAL STUDENTS AND FOR GRADUATES AND FOR UNDERGRADUATES WHO FIND IT DIFFICULT TO UNDERSTAND FROM THE MEDICAL PUBLICATONS ABOUT THIS DISEASE AND ITS DIAGNOSIS AND ALSO DIFFERENTIAL DIAGNOSIS.
Endocrine New Edition
The endocrine system consists of glands that regulate metabolic processes through hormone secretion. Disorders can result from overactivity or underactivity of hormones. Common endocrine disorders include pituitary disorders like hyperpituitarism and hypopituitarism, thyroid disorders like hypothyroidism and hyperthyroidism, and parathyroid disorders like hypoparathyroidism. Symptoms depend on the hormone affected and include fatigue, weight changes, mood issues, and metabolic abnormalities. Treatment involves hormone replacement, medications, surgery, or lifestyle modifications. Nursing care focuses on monitoring for complications, providing support and education, and maintaining fluid and electrolyte balance.
Phaeochromocytoma
A 29-year old man presented to the emergency room with crushing headaches and palpitations. Pheochromocytoma is a rare neuroendocrine tumor that secretes catecholamines and can cause hypertension. It arises from chromaffin cells of the adrenal medulla. Diagnosis involves urine or plasma tests to detect elevated catecholamines and imaging studies like MRI or MIBG scan to locate the tumor. Surgical removal is the primary treatment, along with pre-operative medication to control blood pressure. Lifelong monitoring is needed due to risk of recurrence.
Adrenal gland
The document describes the adrenal gland and its hormones. The adrenal gland has two zones - the adrenal cortex and adrenal medulla. The adrenal cortex secretes three types of hormones: mineralocorticoids, glucocorticoids, and adrenal androgens. Aldosterone is a mineralocorticoid that regulates sodium and potassium levels. Cortisol is the major glucocorticoid and helps regulate carbohydrate, protein, and fat metabolism. It also plays an important role in the body's response to stress.
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Adrenal physiology (1)
The adrenal glands are composed of two regions: the adrenal medulla and adrenal cortex. The adrenal medulla secretes epinephrine and norepinephrine. The adrenal cortex is divided into three zones - the zona glomerulosa, zona fasiculata, and zona reticularis - which secrete mineralocorticoids like aldosterone, glucocorticoids like cortisol, and adrenal androgens. Diseases can result from hypersecretion or hyposecretion of these hormones and include Cushing's syndrome, Conn's syndrome, and Addison's disease. Glucocorticoids increase blood glucose levels, have anti-inflammatory and immune
Glucocorticoids.pptx
HORMONES OF ADRENAL CORTEX Adrenocortical hormones are steroids in nature. Classification
Based on their functions, corticosteroids are classified into three groups:
Ø1. Glucocorticoids
Ø2. Mineralocorticoids
Ø3. Sex hormones.
Cushingsyndromeandaddisondisease 130618105538-phpapp01
The adrenal gland produces three classes of steroid hormones: glucocorticoids, mineralocorticoids, and androgens. These hormones play important roles in metabolism, immune function, blood pressure, and secondary sexual characteristics. Adrenal disorders include Cushing's syndrome (hyperfunction) and adrenal insufficiency (hypofunction). Cushing's syndrome is caused by excessive cortisol levels and can be due to pituitary or adrenal tumors, or ectopic ACTH secretion. Adrenal insufficiency, also called Addison's disease, results from insufficient cortisol and aldosterone and can be caused by autoimmune destruction, infections, or tumors. Both conditions are diagnosed through clinical features and laboratory
Cushing syndrome and addison disease
The adrenal cortex produces three major classes of steroids:
glucocorticoids,
(2) mineralocorticoids, and
(3) adrenal androgens.
Consequently, normal adrenal function is important for
-modulating intermediary metabolism and immune responses through glucocorticoids;
blood pressure, vascular volume, and electrolytes through mineralocorticoids;
secondary sexual characteristics (in females) through androgens.
The adrenal axis plays an important role in the stress response by rapidly increasing cortisol levels.
Adrenal disorders include hyperfunction (Cushing's syndrome) and hypofunction (adrenal insufficiency) as well as a variety of genetic abnormalities of steroidogenesis.
Endocrine Emergencies
The document provides an overview of endocrine emergencies including adrenal crisis, diabetic ketoacidosis, and hypoglycemia. It describes the endocrine system and its functions. Adrenal crisis occurs when the adrenal glands cannot produce adequate hormones in response to stress. Diabetic ketoacidosis results from insulin deficiency and excess stress hormones, causing a buildup of ketones in the blood. Assessment, diagnostic testing, nursing diagnoses, and treatment approaches are outlined for these conditions. The goal is to stabilize vital signs and correct fluid, electrolyte, acid-base, and blood glucose imbalances.
Lecture 5 ( Hyperadrenalism pathology).pdf
The adrenal glands produce important hormones like cortisol and aldosterone. Diseases can cause too much or too little hormone production. Cushing syndrome is caused by excessive cortisol and has symptoms like weight gain and high blood pressure. It can be due to pituitary tumors, ectopic ACTH tumors, or adrenal tumors. Primary hyperaldosteronism is caused by excessive aldosterone and causes low potassium and high blood pressure. Androgen excess from adrenal or gonadal tumors can virilize females or cause precocious puberty in males.
Adrenal cortex 1
The adrenal cortex consists of three layers that secrete different hormones. The zona glomerulosa secretes mineralocorticoids like aldosterone that regulate sodium and potassium levels. The zona fasciculata secretes glucocorticoids like cortisol that regulate carbohydrate, fat and protein metabolism and help the body respond to stress. The zona reticularis secretes small amounts of sex hormones. Diseases can result from too much or too little secretion of these hormones, causing symptoms like high blood pressure, muscle weakness, and changes in fat and sugar levels.
Adrenocortical disorders
The document discusses various endocrine disorders of the adrenal glands including:
1. Pheochromocytoma, a neuroendocrine tumor originating from chromaffin cells that secretes excess adrenaline and noradrenaline.
2. Primary hyperaldosteronism or Conn's syndrome, caused by increased aldosterone secretion primarily from an adrenal adenoma or bilateral adrenal hyperplasia, leading to hypertension and hypokalemia.
3. Cushing's syndrome, caused by prolonged exposure to elevated glucocorticoids, either endogenous from an ACTH-secreting pituitary adenoma or exogenous administration, resulting in obesity, hypertension and immunosuppression.
The Adrenal Gland-converted.pptx
The adrenal glands produce important hormones including cortisol and aldosterone. Cortisol is a glucocorticoid that regulates glucose levels and has anti-inflammatory effects. Aldosterone is a mineralocorticoid that regulates sodium and water balance. The hypothalamus-pituitary-adrenal axis controls cortisol production, while angiotensin II, potassium, and ACTH stimulate aldosterone secretion. Imbalances in these hormones can lead to diseases like Cushing's syndrome or Addison's disease.
Adrenal
This document summarizes the structure and functions of the adrenal cortex. It is divided into three zones: the zona glomerulosa secretes aldosterone and regulates sodium retention; the zona fasciculata secretes cortisol and regulates carbohydrate, fat, and protein metabolism; the zona reticularis secretes sex hormones like androgens. Conn's syndrome and Cushing's syndrome are also summarized, outlining their causes, clinical features, investigations, and treatments. Addison's disease, a condition of chronic adrenal failure, is briefly mentioned at the end.
Hpofunction of adrenal cortex
re-view of physiology of adrenal cortex. congenital adrenal hyperplasia. Disorder of adrenocortical insufficiency - primary and secondary adrenocortical insufficiency.pathology of primary insufficiency. hypoaldosteronism. ACTH stimulation test.
multi day ACTH stimulation test.
Adrenal_physiology by_Abdul_Qahar(A_Q)
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The document discusses the adrenal glands and their functions. It notes that the adrenal glands sit atop the kidneys and are composed of two regions: the adrenal medulla and adrenal cortex. The adrenal medulla secretes epinephrine and norepinephrine. The adrenal cortex secretes corticosteroids and is divided into three zones that produce different hormones. It then discusses the roles and regulation of mineralocorticoids like aldosterone and glucocorticoids like cortisol. Various adrenal disorders are also summarized such as Cushing's syndrome, Conn's syndrome, and Addison's disease.Parathyroid Disorders.pptx
Disorders of the parathyroid glands can cause significant metabolic disturbances that present challenges for anesthesia and surgery. Parathyroid surgery specifically carries risks related to maintaining normal calcium levels. Pre-op optimization is essential to prevent complications from electrolyte imbalances during and after surgery. Careful monitoring of calcium levels is needed both during and after surgery to address any potential hypocalcemia.
Adrenocorticosteroids
The document discusses adrenocorticosteroids and their uses. It describes the adrenal glands and hormones they produce, including mineralocorticoids, glucocorticoids, and adrenal androgens. It outlines the therapeutic uses of adrenocorticosteroids in treating adrenal insufficiency, Cushing's syndrome, inflammatory disorders, and more. Side effects are noted if used long-term or withdrawn abruptly.
Adrenocorticosteroids
The document discusses adrenocorticosteroids and their uses. It describes the adrenal glands and hormones they produce, including mineralocorticoids, glucocorticoids, and adrenal androgens. It outlines the therapeutic uses of adrenocorticosteroids in treating adrenal insufficiency, Cushing's syndrome, inflammatory disorders, and more. Side effects are noted if used long-term or withdrawn abruptly.
Adrenocorticosteroids
The document discusses adrenocorticosteroids and their uses. It describes the adrenal glands and hormones they produce, including mineralocorticoids, glucocorticoids, and adrenal androgens. It outlines the therapeutic uses of adrenocorticosteroids in treating adrenal insufficiency, Cushing's syndrome, inflammatory disorders, and more. Side effects are also summarized.
Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...
Endocrine disease in dentistry /certified fixed orthodontic courses by Indian...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.Endocrinology Notes
Cushing's syndrome is caused by excessive cortisol levels due to hyperfunction of the adrenal glands or pituitary gland. It results in central obesity, mood changes, high blood pressure, and other signs and symptoms. The dexamethasone suppression test is used to diagnose Cushing's syndrome by showing that cortisol levels are not suppressed as expected. Addison's disease is caused by primary adrenal insufficiency leading to cortisol and aldosterone deficiencies. Patients present with weakness, low blood pressure, and hyperpigmentation. The short Synacthen test shows no increase in cortisol levels in response to synthetic ACTH stimulation. Both conditions require lifelong hormone replacement therapy and treatment of underlying causes.
ADRENAL GLAND PATHOLOGY
The document discusses the anatomy and functions of the adrenal glands and their cortex and medulla. It describes various adrenal disorders including adrenocortical hyperfunction (Cushing's syndrome, Conn's syndrome, adrenogenital syndrome), hypofunction (primary and secondary adrenocortical insufficiency, hypoaldosteronism), and tumours (cortical adenoma and carcinoma, pheochromocytoma, neuroblastoma). Cushing's syndrome is most often caused by a pituitary adenoma and results in central obesity, high blood pressure, and skin changes. Conn's syndrome is due to aldosterone-secreting adrenal adenoma and causes hypertension and low potassium levels.
Endocrine system
The adrenal glands secrete important hormones like catecholamines, glucocorticoids, mineralocorticoids, and androgens. Each adrenal gland sits on top of a kidney and is made up of an adrenal medulla that secretes catecholamines and an adrenal cortex that secretes steroid hormones. Disorders of the adrenal glands include pheochromocytoma, a tumor of the adrenal medulla that secretes excess catecholamines and causes hypertension. Diagnosis involves measuring catecholamines in urine or plasma. Treatment consists of medical management with alpha- and beta- blockers to control blood pressure prior to surgical removal of the tumor.
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The umbilical cord
The umbilical cord connects the fetus to the placenta and measures approximately 50 cm in length and 2 cm in diameter at term. It contains one vein that carries oxygenated blood to the fetus and two arteries that carry deoxygenated blood away. The cord inserts into the placenta near its center in most cases. Abnormalities can include abnormal insertion points, short or long length, knots, torsion, hematoma, or having a single umbilical artery instead of two.
The placenta
The placenta develops from fetal and maternal tissues to function as the respiratory, nutritive, excretory, barrier and endocrine organ of pregnancy. It transfers oxygen, nutrients and waste between the mother and fetus. The placenta can develop abnormalities in its shape, size, position or adhesion to the uterine wall which may cause complications like preterm birth or hemorrhage. Placental lesions like infarcts may also occur due to conditions like hypertension.
The foetal membranes
The document discusses the fetal membranes, which include the chorion and amnion. The chorion is the outer membrane that is attached to the placenta and uterine wall. The amnion lines the chorion and encloses the fetus and amniotic fluid. The amniotic fluid provides protection and nutrition for the fetus, and aids in temperature regulation and movement. It is composed primarily of water, carbohydrates, proteins and minerals. The amniotic fluid circulates continuously, with production from the fetal membranes, fetal urine and transudation from maternal and fetal blood.
Physiology of reproduction
The document summarizes the key stages in human reproduction from fertilization through early pregnancy development. It describes how sperm mature and are capacitated in the female reproductive tract. Upon ovulation, sperm meet and fertilize the ovum in the fallopian tubes. The zygote then undergoes cell division and develops into a blastocyst that implants in the uterus. The trophoblast cells of the blastocyst invade the uterine lining and develop into a placenta to exchange nutrients and waste with the mother's blood. Major developmental milestones in early pregnancy include chorion, amnion and decidua formation.
Minor complaints during pregnancy
The document discusses several minor complaints that may occur during pregnancy, including gingivitis, ptyalism, heartburn, constipation, hemorrhoids, varicosities, dyspnea, urinary symptoms, leucorrhea, leg cramps, paraethesia, and backache. For each complaint, the causes and recommended treatments are provided.
Diagnosis of pregnancy
This document discusses the diagnosis of pregnancy over three trimesters. In the first trimester, common symptoms include missed periods, morning sickness, frequent urination, and breast changes. Signs include enlarged, soft breasts and uterus, and a softer, purplish cervix. Pregnancy tests detect human chorionic gonadotropin in urine or blood. Ultrasounds can visualize the gestational sac after 4-5 weeks. In the second trimester, symptoms decrease while the abdomen enlarges and fetal movement is felt. Signs include skin changes and palpable fetal parts. The third trimester confirms pregnancy through palpation of fetal parts and auscultation of the fetal heart.
Antenatal care
Antenatal care involves regular checkups during pregnancy to monitor the health of the mother and baby. Checkups include exams, tests, and education on nutrition, exercise, hygiene, warning signs and avoiding risks. The goals are to prevent or treat complications, detect issues, and ensure healthy development. Women receive more frequent exams as their due date approaches, and are instructed on a nutritious diet, moderate exercise, adequate rest, hygienic practices, and when to seek medical help if problems arise.
Postpartum mood disorders
The document discusses postpartum mood disorders, including prevalence, risk factors, screening tools, diagnosis, and treatment options. It notes that postpartum mood disorders range from mild and temporary postpartum blues to more severe postpartum depression and postpartum psychosis. Screening tools like the Edinburgh Postnatal Depression Scale can help identify at-risk women. Treatment involves psychosocial therapies and may include antidepressant medication depending on severity. A multidisciplinary approach is important to address biological, psychological and social factors.
Normal and abnormal puerperium
Uterine fibroids are benign smooth muscle tumors that develop in the uterus. They are the most common solid pelvic tumors, affecting 20-25% of women during their reproductive years. Fibroids can vary in size and location, and may cause heavy menstrual bleeding, pelvic pressure or pain. Treatment options include observation, medical therapy to reduce estrogen levels, or surgical removal of fibroids.
Version
Version refers to changing the fetal lie or position in the uterus. There are three main types: external cephalic version, internal podalic version, and bipolar podalic version. External cephalic version involves manipulating the fetus externally to convert a breech presentation to head-first. Internal podalic version is performed under anesthesia when the cervix is fully dilated to grasp the fetus's feet and convert a transverse lie to breech. Bipolar podalic version uses both internal and external manipulation through a partially dilated cervix for special circumstances. Complications can include fetal distress, premature separation of the placenta, and maternal hemorrhage.
Vacuum extraction (ventouse)
Vacuum extraction is a method to assist in childbirth using suction from a cup placed on the baby's head to help with traction during contractions. There are different types of cups including metal, soft, and bird's cups. Vacuum extraction is indicated when forceps cannot be used and has advantages over forceps like less need for anesthesia and less compression force applied. Complications can include maternal lacerations and cervical injuries or fetal issues like cephalhematomas and scalp lacerations.
Symphysiotomy
Symphysiotomy is a surgical procedure that divides the symphysis pubis bone to widen the pelvis during childbirth. It is indicated when cephalopelvic disproportion makes vaginal delivery difficult or dangerous but cesarean section is not available or advised. The procedure involves making a small incision above the pubic bone and gradually separating the joint using a scalpel. Complications can include bleeding, injury to nearby organs, infection, and long-term issues like incontinence or an unstable pelvis.
Forceps delivery
This document discusses obstetric forceps, which are metal instruments used to extract a baby's head during delivery. It describes different types of forceps and their proper application techniques. Forceps are indicated for prolonged second stage of labor, maternal distress, or fetal distress. Correct application involves inserting one blade along each side of the baby's head. Potential complications include laceration, hemorrhage, nerve injury, or problems for the baby such as skull fractures. Failure to deliver with forceps may require removal and assessment to determine if cesarean section is needed.
Episiotomy
This document discusses episiotomy, which is an incision made in the perineum during childbirth to widen the vaginal opening. It can help prevent tearing and complications. The two main types are median and mediolateral episiotomies. Median episiotomies involve a midline incision while mediolateral incisions extend laterally towards the ischial tuberosity. Episiotomies are usually performed when the vaginal opening is distended during crowning to prevent stretching injuries. They are sutured closed after delivery.
Caesarean section
The document discusses Caesarean section, including indications, types, procedure, complications, and mode of delivery in subsequent pregnancies. A Caesarean section is a surgical procedure to deliver one or more babies through incisions in the abdomen and uterus. The rate of Caesarean sections has increased from 5% in 1970 to 25% in 1990 due to factors such as abandoning difficult procedures in favor of C-sections and increased use for breech births. Complications can include hemorrhage, infections, and injuries to the mother or baby.
Normal labour
Normal labour involves the spontaneous expulsion of a single, mature fetus through the birth canal within 3-18 hours without complications. It occurs when hormonal and mechanical factors cause the cervix to efface and dilate in stages from 3cm to full 10cm dilation. Labour proceeds through four stages: 1) cervical dilation, 2) expulsion of the fetus, 3) expulsion of the placenta, and 4) recovery. The fetus descends through the birth canal with increased flexion to facilitate delivery of the head.
Anatomy of the foetal skull
The fetal skull consists of three parts: the vault, face, and base. The vault is made up of the frontal, parietal, and occipital bones which are separated by sutures. The face extends from the chin to the nose. Fontanelles are soft spots located where sutures meet which are important for assessing fetal position and flexion. The skull has various longitudinal and transverse diameters used to determine which will engage and pass through the birth canal during delivery.
Anatomy of the female pelvis
The female pelvis is divided into the false pelvis and true pelvis. The true pelvis is further divided into the pelvic inlet, cavity, and outlet. The document describes the boundaries and diameters of each region including the anatomical transverse diameter of 13cm at the inlet. It also discusses the pelvic planes and axes, and the Caldwell-Moloy classification of pelvic types including the gynaecoid, anthropoid, android, and platypelloid pelvis.
Active management of normal labour
This document outlines the active management of normal labour in 4 stages: antenatal preparation, first stage (history, exam, procedures), second stage (delivery of baby), third stage (delivery of placenta), and fourth stage (postpartum care of mother and baby). The goal is a healthy delivery with minimal effects. Key procedures include monitoring contractions/fetal heart with a partogram, positioning, nutrition, analgesia, perineal support, and immediate newborn care.
Thyrotoxicosis in pregnancy
Thyrotoxicosis in pregnancy can cause complications like abortion and preterm labour. Clinical features include weight loss, heat intolerance, tremors, and fast heart rate. It is treated with antithyroid drugs like propylthiouracil or carbimazole. Epilepsy in pregnancy commonly presents as grand mal seizures, which are treated with phenobarbitone or phenytoin along with folic acid. Rhesus isoimmunization occurs when an Rh-negative mother develops antibodies against Rh-positive blood from her baby. It can be prevented by giving the mother anti-D immunoglobulin after delivery or pregnancy events involving blood transfer from baby to mother. Affected babies may require monitoring, phot
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Diseases of adrenal gland
- 23. 1. Cushing Syndrome a) any factor that causes cortisol (i.e., glucocorticoids) i) mainly due to administration of glucocorticoids (iatrogenic) ii) hypersecretion of ACTH iii) hyperplasia or neoplasia iv) ectopic secretion of ACTH www.freelivedoctor.com
- 26. c) known affects of glucocorticoids i) hypertension ii) weight gain (“moon face” “buffalo hump”) iii) atrophy of fast (type II) twitch myofibers muscle atrophy and limb weakness iv) hyperglycemia and glucosuria v) proteolysis and bone resorption (osteoporosis) vi) suppresses immune system risk for infections vii) hirsuitism viii) CNS mood changes www.freelivedoctor.com
- 31. d) adrenal causes of androgens i) neoplasms (more likely to be carcinomas) ii) adrenal hyperplasia - group of autosomal recessive disorders causing cortisol production with feedback in ACTH with resultant adrenal hyperplasia (e.g., congenital) - the most common enzymatic defect in congenital adrenal hyperplasia is 21-hydroxylase deficiency which accounts for ~95% of cases. www.freelivedoctor.com
- 35. d) 21-hydroxylase deficiency causes excessive androgenic activity i) masculinization in females - hirsutism - oligomenorrhea ii) in males, enlargement of external genitalia e) some rare forms of congenital adrenal hyperplasia i) 17- -hydroxylase deficiency ii) in other forms of congenital adrenal hyperplasia (e.g., 11 -hydroxylase deficiency) www.freelivedoctor.com
- 36. - accumulated intermediates steroids have sodium retention properties and subsequent hypertension f) congenital adrenal hyperplasia should be suspected in neonate with ambiguous genitalia i) severe enzyme deficiency in infancy can be life threatening - vomiting - diarrhea - sodium loss (dehydration) ii) in all cases, an androgen producing neoplasm in the ovary must be R/O www.freelivedoctor.com
- 39. - Hashimoto - Pernicious anemia - Type I diabetes - idiopathic Hypoparathyroidism iv) Type I and II polyglandular syndrome - Type I : - autosomal recessive; mutations located on chromosome 21q - Type II : - strong link to histocompatibility antigens (HLA-B8, HLA- DR3 and HLA-DQ5) www.freelivedoctor.com
- 40. v) circulating antibodies to several steroidal enzymes (e.g., 21 and 17 -hydroxylase) have been found in all types of autoimmune adrenalitis b) Infections i) TB (accounted for ~90% of primary chronic adrenocortical insufficiency) antituberculosis drugs have the incidence of Addisons disease ii) Fungi (Histoplasma capsulatum and coccidioides immitis) iii) AIDS, due to contracting a variety of infections www.freelivedoctor.com
- 41. c) Metastatic neoplasms i) common site of metastatic disseminated carcinomas ii) carcinomas of breast and lung are source of majority of metastases in the adrenals iii) other neoplasms from GI, melanomas and hematopoietic neoplasms may also metastasize to the adrenals www.freelivedoctor.com
- 43. d) Primary adrenal insufficiency i) aldosterone Na + loss; K + retention; volume depletion hypotension ii) heart smaller than normal (? Chronic hypovolemia) iii) hypoglycemia (via glucocorticoid deficiency) and impaired gluconeogenesis iv) acute stress in the patients (e.g., infections, surgical procedures, trauma) may initiate an “ acute adrenal crisis ” www.freelivedoctor.com
- 45. iii) DIC iv) overwhelming sepsis (i.e., Waterhouse-Friderichsen syndrome) - classically associated with Nisseria meningitides septicemia - also can be caused by pneumococci, Haemophilus influenza and pseudomonas sp. - pathogenesis unclear (may involve ETX induced vascular damage?) - DIC, shock, skin purpura - more common in children - massive adrenal clots www.freelivedoctor.com
- 51. i) MEN2A and MEN2B ii) type I neurofibromatosis iii) Von Hippel-Lindau disease iv) Sturge-Weber syndrome c) Extra-adrenal source (~10%) i) carotid body ii) organ of Zuckerkandl d) are bilateral (~10%) i) may be as high as 50% in familial cases e) malignant (~10%) i) more common when arise in extra- adrenal sites www.freelivedoctor.com
- 52. f) clinical i) hypertension! - chronic, elevated BP (~70% of cases) ii) other hormones can be secreted - ACTH - somatostatin iii) dx urinary excretion of catecholamines and metabolites - vanillylmandelic acid - metanephrines iv) isolated pheochromocytomas treated surgically - multifocal medically treated www.freelivedoctor.com