Adrenal gland & Cushing's Disease - Seminar August 2015Arun Vasireddy
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.
Adrenal gland & Cushing's Disease - Seminar August 2015Arun Vasireddy
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.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
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Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Home assignment II on Spectroscopy 2024 Answers.pdf
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1.
2.
3. Adrenal glands:
The adrenal glands are paired endocrine organs
consisting of both cortex and medulla, which
differ in their development, structure, and
function.
The adrenal cortex synthesizes three different types
of steroids:
(1) glucocorticoids (principally cortisol)
(2) mineralocorticoids, the most important being
aldosterone
(3) sex steroids (estrogens and androgens)
The adrenal medulla is composed of chromaffin
cells, which synthesize and secrete
catecholamines, mainly epinephrine.
4. Adrenal glands:
Hypercortisolism (Cushing Syndrome)
Exogenous
Endogenous divided into those that are
ACTH dependent
ACTH independent
Adrenal insufficiency(hypoadrenalism)
primary (Addison disease)
secondary
5. Hypercortisolism (Cushing Syndrome)
Pathogenesis:
This disorder is caused by any condition that
produces elevated glucocorticoid levels. Cushing
syndrome can be broadly divided into exogenous
and endogenous causes.
The vast majority of cases of Cushing syndrome
are the result of the administration of exogenous
glucocorticoids (“iatrogenic” Cushing syndrome).
The endogenous causes can, in turn, be divided
into those that are ACTH dependent and those
that are ACTH independent
6.
7. Depending on the cause of the hypercortisolism the
adrenals have :
In patients in whom the syndrome results from
exogenous glucocorticoids, suppression of
endogenous ACTH results in bilateral cortical
atrophy, due to a lack of stimulation of the adrenal
by ACTH.
In contrast, in cases of endogenous hypercortisolism,
the adrenals either are hyperplastic or contain a
cortical neoplasm.
8. The main lesions of Cushing syndrome that are found in
the pituitary and adrenal glands:
(Pituitary gland changes in cushing syndrome)
Crock hyaline changes:
This is the most common change seen in pituitary gland in all
forms of cushing syndrome. In this condition, the normal
granular, basophilic cytoplasm of the ACTH producing cells in
the pituitary is replaced by homogenous, lightly basophilic
material (cytokeratin filaments deposition).
Pituitary Adenomas or foci of ACTH cell hyperplasia.
13. AddisonDisease.
◦ Is uncommon disorder resulting from
progressive destruction of the adrenal cortex.
◦ Clinical features of Addison disease do not appear
until at least 90% of adrenal cortex has been
destructed.
14. Morphology of hypoadrenalism
Gross.
In Addison disease, adrenal glands are shrunken; while in
secondary hypoadrenalism (due to diseases of pituitary &
hypothalamus) adrenal glands are reduced to small,
flattened, yellow structure.
Mic.
In Addison disease, the cortex of adrenal glands contains
only scattered residual cortical cells within the network of
connective tissue, with lymphoid infiltration of the cortex.
15. Clinical features of Addison disease:
Insidious onset of weakness & easy fatigability.
↑K,↓Na,↓BP, due to mineralocorticoid insufficiency.
Hyperpigmentation in primary hypoadrenalism (due to
increase level of POMC precursor to ACTH and
melanocytes stimulating hormone).
Nausea, vomiting & diarrhea.
Hypoglycemia & glycosuria.
Acute stresses (e.g., trauma or infection)
can precipitate acute adrenal crisis, with rapid progression
to deathunless corticosteroid therapy is promptly initiated.
16.
17. Pathology of adrenal medulla.
The most important pathological process in adrenal
medulla is Pheochromacytoma
Pheochromacytoma:
Are neoplasm composed of chromaffin cells, which like
the non neoplastic chromaffin cells synthesize & release
catecholamines (epinephrine, norepinephrine).
Pheochromacytoma can describe by a rule of 10s
10% of pheochromacytoma are familial.
10% are extra- adrenal in their sites (Paraganglioma).
10% of cases are bilateral.
10% are biologically malignant.
18. Gross.
◦ Range from small, circumscribed to large hemorrhagic mass.
Mic.
◦ Composed of polygonal to spindle cells with their supporting
cells, which divide the tumor into small nests (zellaballen) pattern
by a rich vascular network.
◦ Cytoplasm of neoplastic cells is granular (due to their contents of
catecholamines granules).
Even in benign cases, there is vascular & capsular invasion, so the
diagnosis of malignant pheochromacytoma depends on presence
of metastases (to lymph nodes, lung, liver, & bones).
19. Clinical features.
The most characteristic clinical feature of pheochromacytoma is
isolated, paroxysmal, episodes of hypertension in 50% of cases,
with associated symptoms like (tachycardia, palpitation, headache,
tremor, sudden abdominal symptoms).
All these symptoms are due to overproduction of catecholamines
by the neoplastic cells.
Laboratory data (increase urinary excretion of free catecholamines
& their metabolites like Vanilyl Mndelic Aid (VMA).
