1. The adrenal glands are located on the upper poles of each kidney and produce important hormones such as cortisol, aldosterone, and adrenaline.
2. Cushing's syndrome is caused by excessive cortisol production and results in weight gain, high blood pressure, and diabetes. It can be due to exogenous glucocorticoid use or tumors of the pituitary, adrenal glands, or other sites.
3. Primary adrenal insufficiency, also known as Addison's disease, occurs when the adrenal glands do not produce enough cortisol and aldosterone, leading to symptoms like fatigue, low blood pressure, and weight loss. It is often caused by autoimmune
The document discusses prostate cancer and benign prostatic hyperplasia (BPH). It covers the incidence, risk factors, pathology, clinical findings, diagnosis and evaluations, as well as treatments for both conditions. For prostate cancer, it addresses staging and grading. It describes treatments for localized disease and recurrent disease after treatment. For BPH, it discusses symptoms, signs, tests, differential diagnosis, and medical and surgical treatment options.
This slide deck is about Prostate cancer. It is amongst the leading cause of cancer deaths in adult males. This slide deck will provide you with necessary information regarding the symptoms, risk, diagnosis, and possible treatment of prostate cancer. I hope the readers find this slide deck useful & informative
Prostate cancer is the second most common cancer in men worldwide and the second most common cause of cancer death in men. It makes up around 10-15% of all male cancers. Hereditary factors like mutations in the BRCA1 and BRCA2 genes and a family history of prostate cancer can increase the risk. Screening tests for prostate cancer include a digital rectal exam and PSA blood test. Treatment depends on the stage and grade of cancer, and may include surgery, radiation therapy, hormone therapy, chemotherapy, and palliative care.
This document discusses testicular tumors, including their etiology, classification, clinical presentation, diagnosis, staging, and treatment. Some key points:
- Testicular cancer is the most common cancer in men ages 15-35 and has a high cure rate with early detection and treatment.
- Risk factors include cryptorchidism, prior testicular cancer, infertility, and genetic factors. Carcinoma in situ is a precursor to most germ cell tumors.
- Tumors are classified as seminomas or non-seminomas. Staging involves tumor markers, imaging, and pathology to determine extent of disease.
- Treatment involves radical orchidectomy followed by radiotherapy for seminomas or chemotherapy for
Prostate carcinoma is the most common malignancy in males, typically affecting men over 50 years old. On transrectal ultrasound (TRUS), prostate carcinoma usually appears as a hypoechoic lesion in the peripheral zone. Multiparametric MRI with T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences is the most sensitive imaging method for detecting prostate carcinoma, as it can identify restricted diffusion and abnormal enhancement patterns not seen on ultrasound. While imaging is useful for detection and staging of prostate carcinoma, biopsy remains the standard for diagnosis.
This document discusses the value of prostate-specific antigen (PSA) testing and Gleason scoring in the management of prostate cancer. It provides background on PSA biology and testing, outlines the Gleason grading system, and explains how PSA levels and Gleason scores are used for prostate cancer diagnosis, prognosis, treatment selection and follow-up. PSA and Gleason score together provide important information about cancer aggressiveness and help guide clinical decision-making.
anatomy of Prostate and prostate carcinomaRojan Adhikari
This document discusses prostate cancer including its anatomy, epidemiology, diagnosis, and management. Some key points:
1. Prostate cancer most commonly arises from the peripheral zone of the prostate and affects men older than 50 years of age.
2. Diagnosis involves evaluation of PSA levels, digital rectal exam, and transrectal ultrasound-guided biopsy of the prostate.
3. Treatment depends on cancer stage, grade, and risk level. Options include active surveillance, surgery, radiation therapy, hormone therapy, and chemotherapy.
Prostate cancer is the most common non-skin cancer among males. While often slow-growing, it can spread and be fatal. Risk factors include age over 50, family history, and certain genetic factors. Screening involves PSA testing and digital rectal exam, but these have limitations as they may detect cancers that would not have caused harm. Treatment depends on cancer severity and may include active surveillance, surgery, radiation, hormone, or chemotherapy.
The document discusses prostate cancer and benign prostatic hyperplasia (BPH). It covers the incidence, risk factors, pathology, clinical findings, diagnosis and evaluations, as well as treatments for both conditions. For prostate cancer, it addresses staging and grading. It describes treatments for localized disease and recurrent disease after treatment. For BPH, it discusses symptoms, signs, tests, differential diagnosis, and medical and surgical treatment options.
This slide deck is about Prostate cancer. It is amongst the leading cause of cancer deaths in adult males. This slide deck will provide you with necessary information regarding the symptoms, risk, diagnosis, and possible treatment of prostate cancer. I hope the readers find this slide deck useful & informative
Prostate cancer is the second most common cancer in men worldwide and the second most common cause of cancer death in men. It makes up around 10-15% of all male cancers. Hereditary factors like mutations in the BRCA1 and BRCA2 genes and a family history of prostate cancer can increase the risk. Screening tests for prostate cancer include a digital rectal exam and PSA blood test. Treatment depends on the stage and grade of cancer, and may include surgery, radiation therapy, hormone therapy, chemotherapy, and palliative care.
This document discusses testicular tumors, including their etiology, classification, clinical presentation, diagnosis, staging, and treatment. Some key points:
- Testicular cancer is the most common cancer in men ages 15-35 and has a high cure rate with early detection and treatment.
- Risk factors include cryptorchidism, prior testicular cancer, infertility, and genetic factors. Carcinoma in situ is a precursor to most germ cell tumors.
- Tumors are classified as seminomas or non-seminomas. Staging involves tumor markers, imaging, and pathology to determine extent of disease.
- Treatment involves radical orchidectomy followed by radiotherapy for seminomas or chemotherapy for
Prostate carcinoma is the most common malignancy in males, typically affecting men over 50 years old. On transrectal ultrasound (TRUS), prostate carcinoma usually appears as a hypoechoic lesion in the peripheral zone. Multiparametric MRI with T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences is the most sensitive imaging method for detecting prostate carcinoma, as it can identify restricted diffusion and abnormal enhancement patterns not seen on ultrasound. While imaging is useful for detection and staging of prostate carcinoma, biopsy remains the standard for diagnosis.
This document discusses the value of prostate-specific antigen (PSA) testing and Gleason scoring in the management of prostate cancer. It provides background on PSA biology and testing, outlines the Gleason grading system, and explains how PSA levels and Gleason scores are used for prostate cancer diagnosis, prognosis, treatment selection and follow-up. PSA and Gleason score together provide important information about cancer aggressiveness and help guide clinical decision-making.
anatomy of Prostate and prostate carcinomaRojan Adhikari
This document discusses prostate cancer including its anatomy, epidemiology, diagnosis, and management. Some key points:
1. Prostate cancer most commonly arises from the peripheral zone of the prostate and affects men older than 50 years of age.
2. Diagnosis involves evaluation of PSA levels, digital rectal exam, and transrectal ultrasound-guided biopsy of the prostate.
3. Treatment depends on cancer stage, grade, and risk level. Options include active surveillance, surgery, radiation therapy, hormone therapy, and chemotherapy.
Prostate cancer is the most common non-skin cancer among males. While often slow-growing, it can spread and be fatal. Risk factors include age over 50, family history, and certain genetic factors. Screening involves PSA testing and digital rectal exam, but these have limitations as they may detect cancers that would not have caused harm. Treatment depends on cancer severity and may include active surveillance, surgery, radiation, hormone, or chemotherapy.
A 68-year-old man presented with a PSA level of 86 ng/ml but no symptoms. A digital rectal exam found an enlarged prostate that was hard and nodular. This raises concern for prostate cancer. Further tests like biopsy and imaging are needed to confirm the diagnosis and stage the cancer in order to determine the appropriate treatment. Treatment options depend on the risk level and extent of the disease.
This document discusses ureteral injuries, including their etiology, types, anatomy, risk factors, diagnosis, and management. It notes that ureteral injuries most commonly occur during gynecologic surgeries like hysterectomy. Diagnosis involves imaging like IVU, CT scan, or retrograde ureterography. Management depends on the location and severity of injury, and may include ureteroureterostomy, bowel or bladder flaps, nephrectomy, or autotransplantation. Prevention involves identifying anatomical landmarks and avoiding thermal or electrosurgical injuries during surgery.
Prostate cancer is the most common cancer in men. While some prostate cancers are small and clinically insignificant, others can be rapidly fatal. The percentage of free PSA to total PSA is lower in men with prostate cancer. Microscopically, prostate cancer shows pleomorphic cells in single layer glands without secretions, unlike the normal double layer glands. Gleason scoring is used to grade prostate cancers from 1 to 10 based on their appearance under microscopy. Staging helps determine prognosis, with stage 1 having a 90% 5-year survival rate compared to 10% for stage 4 cancers.
Screening for Prostate cancer has had many different opinions and much research has been conducted in the last 20 years. In this presentation we will discuss the current guidelines for proper screening and gain more insight into men’s health.
It is not for practicing, only general description of prostate cancer.......of my presentation . for explanation study authentic books also .....and webs.
Prostate cancer is the most common cancer in men and the second leading cause of cancer death. It occurs when cells in the prostate gland grow abnormally. There are often no early symptoms but some men experience urinary issues or discomfort. Treatment options include surgery, chemotherapy, cryotherapy, hormonal therapy, and watchful waiting. Screening tools include digital rectal exams, transrectal ultrasound, and PSA tests.
This document provides an overview of the anatomy and surgical procedures related to the prostate gland. It begins with the surgical anatomy of the prostate, including its relations to surrounding structures, coverings, lobes, blood supply, lymphatic drainage and innervation. It then discusses various prostate surgeries like TURP, open and laparoscopic prostatectomy. It concludes with potential complications of prostate surgery, such as injuries, urinary incontinence, and issues with erection, ejaculation and fertility. Videos are also embedded to demonstrate different prostate procedures.
The document discusses testicular cancer and provides details on its epidemiology, classification, staging, diagnosis, and disease management. Some key points:
- Testicular cancer peaks in the third decade for non-seminoma and fourth decade for seminoma. Risk factors include cryptorchidism, family history, and subfertility.
- Germ cell tumors are divided into seminoma and non-seminomatous tumors including embryonal carcinoma, teratoma, and choriocarcinoma.
- Stage I disease accounts for 75-80% of seminoma and 55% of non-seminoma cases at diagnosis. Serum tumor markers and imaging help determine diagnosis and staging.
This document provides an overview of testicular cancer, including:
1. Testicular cancer most commonly affects men aged 20-40 and is the most common cancer in that age group. It has very good survival rates due to effective diagnostic techniques, tumor markers, and multimodal treatments.
2. Risk factors include cryptorchidism, Klinefelter syndrome, trauma, and genetic factors. Cryptorchidism increases risk by 14-48 times.
3. Types include seminomas, embryonal carcinomas, teratomas, and others. Seminomas and non-seminomas are treated differently.
4. Diagnosis involves physical exam, ultrasound, tumor markers like AFP and H
The document discusses pancreatic neuroendocrine tumors. It covers types like insulinomas, gastrinomas, vipomas, glucagonomas, and somatostatinomas. For each type it discusses incidence, location, clinical features, diagnostic tests, management options like surgery or medication, and prognosis. It also covers non-functional pancreatic neuroendocrine tumors and tumors associated with MEN1 syndrome. Surgical resection is the primary treatment when possible but some types are often metastatic at diagnosis.
This document provides information about testicular tumors. It discusses that testicular cancer is most common in men aged 15-35 and has three peaks in incidence. The most common types are seminomas and non-seminomas. Risk factors include cryptorchidism, Klinefelter's syndrome, and trauma. Diagnosis involves physical exam, ultrasound, serum tumor markers, and radiology. Treatment depends on the type and stage but generally includes radical orchidectomy followed by chemotherapy, radiation, or surveillance. Prognosis is excellent even for metastatic disease due to chemosensitivity.
This document provides information on testicular tumors, including their epidemiology, risk factors, classification, types, clinical features, investigations, staging, and spread. Some key points:
- Testicular tumors comprise 1-2% of all malignancies and 95% are germ cell tumors (GCTs), which predominantly affect young males.
- Risk factors include cryptorchidism, family history, prior testicular cancer, intratubular germ cell neoplasia, and environmental exposures.
- The main types of GCTs are seminoma, embryonal carcinoma, choriocarcinoma, yolk sac tumor, and teratoma.
- Clinical features depend on whether the
An adrenal incidentaloma is an adrenal mass discovered incidentally on imaging done for other reasons. Most are non-functioning adrenal adenomas. Evaluation involves assessing for hormone hypersecretion and malignancy risk based on size, imaging characteristics, and functional tests. Surgery is indicated for functional tumors, suspected or confirmed adrenal cortical carcinoma, symptomatic masses, and non-functional masses over 4 cm or showing signs of malignancy on imaging. Biopsy has limitations due to risk of complications and false negatives. Close follow-up may be appropriate for some non-functional incidentalomas under 4 cm.
This document summarizes statistics on prostate cancer incidence and mortality rates in the United States from 1975 to 2009. It also discusses results from several major clinical trials comparing prostate cancer screening to no screening, and radical prostatectomy to observation for localized prostate cancer. The key findings are:
1) Prostate cancer incidence peaked in 1992 but mortality rates have been declining since the 1990s.
2) Large screening trials show screening increases prostate cancer diagnosis but does not reliably decrease prostate cancer mortality.
3) The PIVOT trial found that among men with localized prostate cancer, radical prostatectomy resulted in a 2.9% lower rate of death from any cause and a 2.6% lower rate of death from prostate
This case discusses a 35-year-old woman named Saher who is concerned about her risk of colorectal cancer due to her family history. Saher's aunts died of colorectal cancer at age 54, her father had intestinal polyps, and her grandmother had uterine cancer and died at age 48. The document discusses that colorectal cancer can be inherited through gene mutations. It explains that Saher most likely has Lynch syndrome, the most common form of hereditary colorectal cancer caused by a defective mismatch repair gene. The document recommends screening and provides prevention strategies like diet, exercise and prophylactic surgery to help manage Saher's risk and the risks to her children.
Prostate cancer is the most commonly diagnosed cancer and second leading cause of cancer death among men over 65 in Western countries. Risk factors include increasing age, family history, and diet. Histopathological grading uses the Gleason grading system to determine tumor differentiation and prognosis. Treatment options depend on disease stage and include local therapies like surgery and radiation for early disease, hormone therapy for advanced or metastatic disease, and chemotherapy for hormone-refractory prostate cancer.
Current Diagnosis And Management Of Prostate Cancerfondas vakalis
1) Prostate cancer risk factors include increasing age, family history, and lifestyle factors like smoking and high fat diets.
2) Screening methods include digital rectal exam and PSA testing, though screening recommendations vary.
3) Treatment options depend on cancer severity and include watchful waiting, surgery, radiation, hormone therapy, and cryotherapy. Long-term side effects can include incontinence and impotence.
The document discusses carcinoma of the prostate, including:
1. It provides information on prostate anatomy and the distribution and risk factors of prostate cancer.
2. Early detection is important as survival rates are 99% for localized cancer but only 31% once it has spread; screening involves digital rectal exams and PSA tests beginning at age 40-50.
3. Treatment options depend on the stage and grade of cancer, and include watchful waiting, surgery, radiation therapy, and hormone therapy.
Gastric cancer is the second most common fatal cancer worldwide. It most commonly presents in the 5th and 6th decades of life and affects males twice as often as females. The vast majority are adenocarcinomas that arise from chronic gastritis and intestinal metaplasia. Gastric cancers are broadly classified into polyps and carcinomas, with adenocarcinoma making up about 90% of carcinomas. Early gastric cancer is confined to the mucosa and submucosa, while advanced gastric cancer has invaded deeper into the stomach wall.
Adrenal gland diseases,Cushing syndrome,Addison disease and PheochromocytomaJonathan Chikomele
The document discusses adrenal gland diseases including Cushing syndrome, Addison's disease, and pheochromocytoma. It provides details on the anatomy and function of the adrenal glands, describing the location, layers, and hormone production. It then focuses on Cushing syndrome, outlining its definition, potential causes, signs and symptoms, diagnostic tests including the dexamethasone suppression test, and treatment options including medication, surgery, and radiation therapy. Addison's disease and its causes, signs, laboratory findings, and pathogenesis are also summarized.
Adrenal disorder.ppt for nephrology inpediatricAbdulkadirHasan
The document discusses adrenal gland physiology and diseases. It covers:
1) The adrenal gland's structure and hormone production in the cortex and medulla.
2) Regulation of cortisol, aldosterone, and androgens by ACTH, renin-angiotensin, and other factors.
3) Cushing syndrome and adrenal insufficiency, their causes, signs/symptoms, investigations, and treatments.
A 68-year-old man presented with a PSA level of 86 ng/ml but no symptoms. A digital rectal exam found an enlarged prostate that was hard and nodular. This raises concern for prostate cancer. Further tests like biopsy and imaging are needed to confirm the diagnosis and stage the cancer in order to determine the appropriate treatment. Treatment options depend on the risk level and extent of the disease.
This document discusses ureteral injuries, including their etiology, types, anatomy, risk factors, diagnosis, and management. It notes that ureteral injuries most commonly occur during gynecologic surgeries like hysterectomy. Diagnosis involves imaging like IVU, CT scan, or retrograde ureterography. Management depends on the location and severity of injury, and may include ureteroureterostomy, bowel or bladder flaps, nephrectomy, or autotransplantation. Prevention involves identifying anatomical landmarks and avoiding thermal or electrosurgical injuries during surgery.
Prostate cancer is the most common cancer in men. While some prostate cancers are small and clinically insignificant, others can be rapidly fatal. The percentage of free PSA to total PSA is lower in men with prostate cancer. Microscopically, prostate cancer shows pleomorphic cells in single layer glands without secretions, unlike the normal double layer glands. Gleason scoring is used to grade prostate cancers from 1 to 10 based on their appearance under microscopy. Staging helps determine prognosis, with stage 1 having a 90% 5-year survival rate compared to 10% for stage 4 cancers.
Screening for Prostate cancer has had many different opinions and much research has been conducted in the last 20 years. In this presentation we will discuss the current guidelines for proper screening and gain more insight into men’s health.
It is not for practicing, only general description of prostate cancer.......of my presentation . for explanation study authentic books also .....and webs.
Prostate cancer is the most common cancer in men and the second leading cause of cancer death. It occurs when cells in the prostate gland grow abnormally. There are often no early symptoms but some men experience urinary issues or discomfort. Treatment options include surgery, chemotherapy, cryotherapy, hormonal therapy, and watchful waiting. Screening tools include digital rectal exams, transrectal ultrasound, and PSA tests.
This document provides an overview of the anatomy and surgical procedures related to the prostate gland. It begins with the surgical anatomy of the prostate, including its relations to surrounding structures, coverings, lobes, blood supply, lymphatic drainage and innervation. It then discusses various prostate surgeries like TURP, open and laparoscopic prostatectomy. It concludes with potential complications of prostate surgery, such as injuries, urinary incontinence, and issues with erection, ejaculation and fertility. Videos are also embedded to demonstrate different prostate procedures.
The document discusses testicular cancer and provides details on its epidemiology, classification, staging, diagnosis, and disease management. Some key points:
- Testicular cancer peaks in the third decade for non-seminoma and fourth decade for seminoma. Risk factors include cryptorchidism, family history, and subfertility.
- Germ cell tumors are divided into seminoma and non-seminomatous tumors including embryonal carcinoma, teratoma, and choriocarcinoma.
- Stage I disease accounts for 75-80% of seminoma and 55% of non-seminoma cases at diagnosis. Serum tumor markers and imaging help determine diagnosis and staging.
This document provides an overview of testicular cancer, including:
1. Testicular cancer most commonly affects men aged 20-40 and is the most common cancer in that age group. It has very good survival rates due to effective diagnostic techniques, tumor markers, and multimodal treatments.
2. Risk factors include cryptorchidism, Klinefelter syndrome, trauma, and genetic factors. Cryptorchidism increases risk by 14-48 times.
3. Types include seminomas, embryonal carcinomas, teratomas, and others. Seminomas and non-seminomas are treated differently.
4. Diagnosis involves physical exam, ultrasound, tumor markers like AFP and H
The document discusses pancreatic neuroendocrine tumors. It covers types like insulinomas, gastrinomas, vipomas, glucagonomas, and somatostatinomas. For each type it discusses incidence, location, clinical features, diagnostic tests, management options like surgery or medication, and prognosis. It also covers non-functional pancreatic neuroendocrine tumors and tumors associated with MEN1 syndrome. Surgical resection is the primary treatment when possible but some types are often metastatic at diagnosis.
This document provides information about testicular tumors. It discusses that testicular cancer is most common in men aged 15-35 and has three peaks in incidence. The most common types are seminomas and non-seminomas. Risk factors include cryptorchidism, Klinefelter's syndrome, and trauma. Diagnosis involves physical exam, ultrasound, serum tumor markers, and radiology. Treatment depends on the type and stage but generally includes radical orchidectomy followed by chemotherapy, radiation, or surveillance. Prognosis is excellent even for metastatic disease due to chemosensitivity.
This document provides information on testicular tumors, including their epidemiology, risk factors, classification, types, clinical features, investigations, staging, and spread. Some key points:
- Testicular tumors comprise 1-2% of all malignancies and 95% are germ cell tumors (GCTs), which predominantly affect young males.
- Risk factors include cryptorchidism, family history, prior testicular cancer, intratubular germ cell neoplasia, and environmental exposures.
- The main types of GCTs are seminoma, embryonal carcinoma, choriocarcinoma, yolk sac tumor, and teratoma.
- Clinical features depend on whether the
An adrenal incidentaloma is an adrenal mass discovered incidentally on imaging done for other reasons. Most are non-functioning adrenal adenomas. Evaluation involves assessing for hormone hypersecretion and malignancy risk based on size, imaging characteristics, and functional tests. Surgery is indicated for functional tumors, suspected or confirmed adrenal cortical carcinoma, symptomatic masses, and non-functional masses over 4 cm or showing signs of malignancy on imaging. Biopsy has limitations due to risk of complications and false negatives. Close follow-up may be appropriate for some non-functional incidentalomas under 4 cm.
This document summarizes statistics on prostate cancer incidence and mortality rates in the United States from 1975 to 2009. It also discusses results from several major clinical trials comparing prostate cancer screening to no screening, and radical prostatectomy to observation for localized prostate cancer. The key findings are:
1) Prostate cancer incidence peaked in 1992 but mortality rates have been declining since the 1990s.
2) Large screening trials show screening increases prostate cancer diagnosis but does not reliably decrease prostate cancer mortality.
3) The PIVOT trial found that among men with localized prostate cancer, radical prostatectomy resulted in a 2.9% lower rate of death from any cause and a 2.6% lower rate of death from prostate
This case discusses a 35-year-old woman named Saher who is concerned about her risk of colorectal cancer due to her family history. Saher's aunts died of colorectal cancer at age 54, her father had intestinal polyps, and her grandmother had uterine cancer and died at age 48. The document discusses that colorectal cancer can be inherited through gene mutations. It explains that Saher most likely has Lynch syndrome, the most common form of hereditary colorectal cancer caused by a defective mismatch repair gene. The document recommends screening and provides prevention strategies like diet, exercise and prophylactic surgery to help manage Saher's risk and the risks to her children.
Prostate cancer is the most commonly diagnosed cancer and second leading cause of cancer death among men over 65 in Western countries. Risk factors include increasing age, family history, and diet. Histopathological grading uses the Gleason grading system to determine tumor differentiation and prognosis. Treatment options depend on disease stage and include local therapies like surgery and radiation for early disease, hormone therapy for advanced or metastatic disease, and chemotherapy for hormone-refractory prostate cancer.
Current Diagnosis And Management Of Prostate Cancerfondas vakalis
1) Prostate cancer risk factors include increasing age, family history, and lifestyle factors like smoking and high fat diets.
2) Screening methods include digital rectal exam and PSA testing, though screening recommendations vary.
3) Treatment options depend on cancer severity and include watchful waiting, surgery, radiation, hormone therapy, and cryotherapy. Long-term side effects can include incontinence and impotence.
The document discusses carcinoma of the prostate, including:
1. It provides information on prostate anatomy and the distribution and risk factors of prostate cancer.
2. Early detection is important as survival rates are 99% for localized cancer but only 31% once it has spread; screening involves digital rectal exams and PSA tests beginning at age 40-50.
3. Treatment options depend on the stage and grade of cancer, and include watchful waiting, surgery, radiation therapy, and hormone therapy.
Gastric cancer is the second most common fatal cancer worldwide. It most commonly presents in the 5th and 6th decades of life and affects males twice as often as females. The vast majority are adenocarcinomas that arise from chronic gastritis and intestinal metaplasia. Gastric cancers are broadly classified into polyps and carcinomas, with adenocarcinoma making up about 90% of carcinomas. Early gastric cancer is confined to the mucosa and submucosa, while advanced gastric cancer has invaded deeper into the stomach wall.
Adrenal gland diseases,Cushing syndrome,Addison disease and PheochromocytomaJonathan Chikomele
The document discusses adrenal gland diseases including Cushing syndrome, Addison's disease, and pheochromocytoma. It provides details on the anatomy and function of the adrenal glands, describing the location, layers, and hormone production. It then focuses on Cushing syndrome, outlining its definition, potential causes, signs and symptoms, diagnostic tests including the dexamethasone suppression test, and treatment options including medication, surgery, and radiation therapy. Addison's disease and its causes, signs, laboratory findings, and pathogenesis are also summarized.
Adrenal disorder.ppt for nephrology inpediatricAbdulkadirHasan
The document discusses adrenal gland physiology and diseases. It covers:
1) The adrenal gland's structure and hormone production in the cortex and medulla.
2) Regulation of cortisol, aldosterone, and androgens by ACTH, renin-angiotensin, and other factors.
3) Cushing syndrome and adrenal insufficiency, their causes, signs/symptoms, investigations, and treatments.
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.
The document discusses the management of Addisonian crisis, which is a life-threatening condition caused by nonfunctional adrenal glands. It describes the adrenal glands and their normal function. An Addisonian crisis occurs when the adrenal glands are almost completely nonfunctional and can cause severe hypotension, hypoglycemia, and other metabolic derangements. Precipitants include infection, trauma, withdrawal from steroids, or adrenal insufficiency in the face of stress. Treatment involves rapid intravenous steroid administration to reverse the crisis along with fluid resuscitation and investigating for an underlying infection.
This document discusses disorders of the adrenal cortex. It begins by outlining the learning objectives, which are to understand the etiology, pathophysiology, clinical manifestations, diagnostics, treatment, nursing care, and complications of adrenal cortex disorders. It then provides an overview of adrenal gland disorders in general before focusing specifically on the adrenal cortex and its hormones. Key points covered include the causes, symptoms, diagnostic tests, and treatment of adrenal hypofunction conditions like Addison's disease and adrenal hyperfunction conditions.
Cushing's syndrome is defined as a state of chronic glucocorticoid excess leading to symptoms and signs of hypercortisolism regardless of the cause. The most common cause is Cushing's disease, which is due to excessive ACTH secretion from a pituitary tumor. Other causes include ectopic ACTH syndrome from a non-pituitary tumor and adrenal tumors such as adenomas. Clinical features include central obesity, hypertension, skin changes like striae, psychiatric symptoms, and metabolic derangements. Diagnosis involves biochemical testing for hypercortisolism and imaging tests to determine the underlying cause. Treatment depends on the specific cause but may include pituitary surgery, radiotherapy, or medical therapy with drugs. Prognosis
Adrenal Gland Tumours and their ManagementFaisal Zia
The document discusses adrenal gland tumors and their management. It begins with the anatomy and physiology of the adrenal glands and outlines the classification of adrenal tumors. It then discusses specific tumor types like adrenocortical adenoma, adrenocortical carcinoma, pheochromocytoma, neuroblastoma, and ganglioneuroma. For each tumor, it covers clinical features, diagnosis, and management strategies including surgery, medication, and follow up. Surgical resection is the primary treatment for most benign functioning and non-functioning tumors, while malignant tumors may also require chemotherapy or radiation.
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.
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 involved in glucose metabolism, mineral balance, and sexual development. The medulla secretes catecholamines which increase heart rate and blood pressure. Diseases can result from hypo- or hyperfunction of the adrenal cortex or medulla. Tests are used to identify the cause and guide treatment options such as surgery or medication.
1. The adrenal glands sit above the kidneys and have two parts - the inner adrenal medulla and outer adrenal cortex.
2. Primary hyperaldosteronism (Conn's syndrome) is caused by excessive aldosterone and results in hypertension. It can be treated by surgery or medication.
3. Cushing's syndrome is excessive cortisol and can be ACTH-dependent or independent. It is usually diagnosed by hormone tests and treated by surgery, medication, or radiation depending on the cause.
The adrenal glands produce steroid and catecholamine hormones that help regulate metabolism, blood pressure, and the immune system. Adrenal disorders can cause hormone overproduction or underproduction. Cushing's syndrome results from glucocorticoid excess and causes high blood pressure, weight gain, and metabolic changes. Addison's disease is a deficiency of cortisol and aldosterone that results in low blood pressure, fatigue, and electrolyte imbalances. Adrenal tumors can be benign or malignant and may overproduce hormones like cortisol or catecholamines, requiring treatment with surgery, medication, or other therapies depending on the type and stage of the tumor.
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.
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
Cushing's syndrome is caused by prolonged high levels of cortisol and results in specific signs and symptoms. It is usually caused by a pituitary tumor that overproduces ACTH or an adrenal tumor that secretes cortisol. Common signs include central obesity, high blood pressure, diabetes, and easy bruising. Diagnosis involves blood and urine tests to check cortisol levels along with imaging tests of the pituitary and adrenal glands. Treatment options depend on the cause but may include surgery, radiation, or medications to reduce cortisol production. Nursing care focuses on monitoring for infections, injury prevention, managing activity levels, and skin integrity.
The document discusses Addison's disease, including its causes from adrenal gland dysfunction, signs and symptoms like low blood pressure and weight loss, treatment through glucocorticoid and mineralocorticoid replacement, and nursing management such as monitoring vital signs and instructing patients on adjusting medication doses during times of stress.
This document provides information on disorders of the adrenal gland. It begins with the anatomy and embryology of the adrenal glands. It then discusses the histology and functions of the adrenal cortex and medulla. Some key conditions covered include Cushing's syndrome, hyperaldosteronism, congenital adrenal hyperplasia, and adrenocortical insufficiency. Specific lesions like adrenocortical adenomas and carcinomas are also described.
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How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
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Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
2. Position and location
■ The adrenal glands located on the upper poles of
each kidney on the right and left sides
■ They are covered by peritoneum on the
posterior abdominal wall they are embedded
into pre renal fat
■ The left one is larger and higher than the right
3. The right adrenal gland
■ It is triangular in shape located on the upper
pole of the right kidney behind the inferior vena
cava
■ It is related anterior to the inferior vena cava and
the right lobe of the liver
■ Posterior it is related to the right cruse of
diaphragm
4. The left adrenal gland
■ It is crescent in shape located on the upper pole
of the left kidney behind the stomach
■ Anterior it is related to the stomach, the tail of
pancreas and the lesser sac
■ Posterior it is related to the left cruse of
diaphragm
5. The blood supply
■ Each adrenal gland supply by three arteries superior
,middle and inferior suprarenal arteries
■ The superior supra renal artery branch from inferior
■
phernicarterywhichisbranchfromthe aorta, the
middle supra renal artery branch from the aorta and the
inferior supra renal artery branch from the renal artery
Thevenousdrainagebythesuprarenalveinonthe
right side at the inferior venacavaand on the left side
at the left renal vein
7. Structure of adrenal gland
■ The adrenal gland formed of outer cortex which
isyellowformingthe main mass of the gland
and inner medulla completely enclosed by the
cortex except at the hilum the gland enclosed by
capsule of connective tissue
■ The cortex has mesodermdevelopment while
the medulla developed from the neural crest
9. The adrenal cortex
■ The cortex of the adrenal cortex consist of three layers
arrangedfromouterto innerthezonaglomerulosa,
fasciculata, and reticularis
■ Zona glomerulosa : it is the outer layer located close
to the capsule .
■ itiscellsstimulatedbyACTH andangiotensin2to
secretmineralocorticoidshormoneswhicharethe
aldesterone , they control thefluid and electrolytes
balance in the body by affecting the renal tubules
10. Zona fasciculata
■ It is the middle largest layer of the cortex
■ thecellsof thislayersecrettheglucocorticoids
which are the cortisol and hydrocortisone which
are maintain the carbohydrate balance
11. Zona reticularis
■ It is the inner layers it is cells secret the
gonadocorticoids hormone which are the
estrogen and androgen which supplemented the
sex hormones for both men and women
15. Aldosterone
■ Target Cell:
■ Kidneys!
■ Exocrine Glands
■ Effect of Hormone:
■ Maintains balance of Na+in the bloodstream
■ aldosterone conservation of Na+
16.
17. Cortisol
■ Produced when ACTH levels are high!
■ Act as negative feedback for the pituitary gland
■ Converts adipose tissue
to glucose!
■ Occurs during high
stress periods
■Emotional distress
■Physical distress
(exercise,
hemorrhage)
18.
19. Androgens
■ “male” sex hormone
■ Converted to Testosterone in Males !
■ Convertedto Estrogen in Females!
20. Adrenal medulla
■ The adrenal medulla developed from the neural crest it
isformedof groupandcolumnsof cellscalled
chromaffin cells
■ The chromaffin cells secreted the adrenalin and
noradrenalin which they activated the sympathetic
stimulation
22. Epinephrine
■ Stimulated by Sympathetic Nervous System
to initiate “fight or flight” response!
■ Stored in adrenal gland until needed!
■ Effects of Epinephrine
■
■
■
blood sugar
heart rate
blood flow to brain, heart, muscles
23. Clinical problems
■ Variousclinicalconditiondueto thelesionof the
adrenalcortexormedullaaffect thesecretionof the
adrenal hormone hyper secretion of the hormones of
the adrenal cortex result in Cushing syndrome which
characterized by redistribution of fat the spindle limbs,
swollen face, diabetes mellitus and slow of wound
heeling the
■ HyposecretioncausetheAddisondiseasewhichis
characterized by weight loss muscular weakness and
hypoglycemia, low blood pressure and dehydration
25. CUSHING SYNDROME
Definition
•Cushing’s syndrome: constellation of symptoms
associated with cortisol excess.
•Cushing's syndrome develops when the level of a
glucocorticoid in the body is too high over a long
period of time.
•Too much glucocorticoid can occur from an
exogenous or endogenous source
•described by Harvey Cushing in 1932
28. Clinical presentations
Findings are more obvious in infants
• ⚫Children with adrenal tumors
Signs of abnormal masculinization
• ⚫Growth impairment
Short stature
• Decreased collagen cause purplish striae on soft tissues of
the body
• They are prone to infections due to compromised immune
system
• Decreased linear growth
29.
30.
31. Diagnosis of Cushing’s Syndrome
• Obtain a careful history to exclude exogenous glucocorticoid
use.
• Perform at least two first-line biochemical tests to
obtain the diagnosis:
• Urine free cortisol (UFC) (at least two measurements)
• Late-night salivary cortisol (two measurements)
• In +ve tests Morning and midnight plasma cortisol levels are
elevated
• Serum ACTH level
• Bloods tests
- FBC
- U/E – low K
32. Diagnosis
•Cortisol levels in blood are normally elevated at 8
A.M. and decrease to less than 50% by midnight
•In patients with Cushing syndrome this circadian
rhythm is lost, and cortisol levels at midnight and 8
A.M. are usually comparable.
• Urinary excretion of free cortisol is increased. This
is best measured in a 24-hr urine sample and is
expressed as a ratio of micrograms of cortisol
excreted per gram of creatinine
33. Dexamethasone suppression test
• Given low dose of dexamethasone (which is
exogenous steroid that suppress ACTH
production of th epitituary gland)
• Normally should cause decrease in cortisol
level
• If cushing syndrome cause by endogenous
cortisol production, the the serum cortisol
should remain unchanged.
• If that test is positive the next step is to
determine the exact cause of endogenous
cortisol and acth production
34. ACTH Plasma Level
• Low ACTH can be seen in adrenal adenoma
and carcinoma
• High ACTH level can be seen in cushing
disease and ectopic ACTH production
• If ACTH level high, the next step is to give
high dose of dexamethasone
• Unlike pitituary adenoma, ectopis site of
ACTH won’t response to high dose of
dexamethasone and the serum cortisol will
remain high
35. IMAGING
• An MRI of the pitituary gland in the
case of cushing disease
• CT scan of the adrenal when adrenal
pathology is suspected
• Ct of chest, abdomen and pelvis if
the seems to be an ectopic site of
ACTH production
37. •Dx of Cushing syndrome has been established
then,the next step is to find out the cause
↓
Serum ACTH level
•If low or undetectable– ACTH independent
cause [Adrenal cause likely]
•If high– Cushing’s disease or Ectopic ACTH
syndrome
•Two differentiate between these two: High dose DST
is to be done
41. Medical therapy
Purpose
• Correct metabolic abnormalities before attempted
surgical cure
• Palliate surgically non curable disease
• Achieve remission in patients for whom surgery is
unlikely to achieve satisfactory long term results
42. EXOGENOUS MEDICATION
Drug is gradually decrease
Avoid sudden withdrawal, can lead to Addisonian crisis
Pitituary adenoma
Surgical excision
43. Surgical tx
Cushing’s disease
◦Trans sphenoidal
microadenomectomy
◦Pituitary radiation
◦Bilateral total adrenalectomy
Adrenal adenoma and
carcinoma
◦Surgical removal
Ectopic ACTH Syndrome
◦Surgical removal of the
ectopic tumor
◦Radiotherapy
44. Adrenal Insufficiency
• Primary Adrenal Insufficiency is also known asAddison’s Disease in
honor of Dr. ThomasAddison
• Dr.Addison is also credited with the discovery of PerniciousAnemia
• Addison's disease is serious chronic disease, caused by partial or
absolute abnormality of hormonal function of the adrenal cortex due
to its two-sided disorder (first it was described by Tomas Addison in
1855).
45. Adrenal Insufficiency
•Arises when cortisol levels are not sufficient
to meet the needs of the body
•May be primary or secondary
•May be congenital or acquired
•It develops at the age of 20-40 years old
•Can be fatal if left untreated
48. Etiology
•Most commonly is of an autoimmune
etiology, resulting from chronic destruction
of the adrenal cortex
•Typical histologic feature is lymphocytic
infiltration
•Antibodies to adrenal cortical antigens are
present early in the disease process
•Patients with autoimmune adrenal disease
are more likely to have polyglandular
autoimmune systems causing deficiency of
other endocrine glands
49. Clinical Presentation
•Symptoms may include weakness, weight loss, nausea,
vomiting, anorexia, and postural
hypotension,Hyperpigmentation,Hypotension,
Orthostatic changes,Weak pulses,Shock
•Loss of axillary/pubic hair (women)
•Increased skin pigmentation can be seen with primary
adrenal insufficiency secondary to melanocyte
stimulating activity associated with ACTH
•Hyponatremia and Hyperkalemia may develop
secondary to a lack of aldosterone
50.
51. LABORATORY DIAGNOSTICS
In the blood analysis: lymphocytosis, eosinophilia,
erythrocyte sedimentation rate is decreased, when the active
tuberculosis is present this rate is increased;
The electrolyte: hyponatremia, hypochloremia,
hyperkaliemia;
Baseline Cortisol and ACTH levels should be obtained in the
early morning
The content of ACTH is increased;
The content of cortisol is decreased;
The concentration of glucose in the blood is decreased;
The glucose tolerance test – flat with marked
hypoglycemic phase in three hours;
The potassium flow with urine is decreased, the natrium
and chlorine flow is increased.
53. Treatment
•Replacement ( always need glucocorticoids and
usually mineralcorticoid therapy)
•Hydrocortison orally 15 mg at morning and 5 mg
at evening
•Doses change according to lifestyle:
-doubling the routine oral dose in the case
of intercurrent illness with fever
-IV hydrocortisone injection at a daily dose of 100
mg in cases of prolonged vomiting, surgery, or
trauma
•Have to carry emergency injection of
hydrocortisone and card/bracelet indentifying
their condition
54. •Mineralocorticoid replacement in primary AI
(100–150 g fludrocortisone). The adequacy
of treatment can be evaluated by measuring
BP, sitting and standing to detect a postural
drop indicative of hypovolemia, serum Na, k,
and plasma renin should be measured
regularly.
•Adrenal androgen replacement is an option in
patients with lack of energy, and in women
with loss of libido.
- It can be achieved by once-daily
administration of 25–50 mg DHEA. Treatment
is monitored by measurement of DHEAS,
androstenedione, testosterone.
55. Treatment
Special precautions
•During intercurrent illness,trauma,surgery, esp in
fever, the dose of hydrocortisone should be
doubled
•Increase the dose of fludrocortisone and to add
salt in strenuous exercise with sweating, extremely
hot weather, gastrointestinal upsets such as diarrhea
•Pts receiving long term steroid therapy have
two deficits
1.adrenal atrophy secondary to the loss of
endogenous ACTH
2.failure of pituitary ACTH release have low blood
cortisol, ACTH levels, and abnormal ACTH stimulation
test
56. ADDSONIAN CRISIS (ACUTE
PRIMARY ADRENAL INSUFFIENCY)
•Severely low blood pressure (shock)
•Hyperkalemia
•Hyponatremia
•Hypoglycemia
•Hypercalcemia
•Unexplained fever, diarrhea, vomiting
•Coma and death
•Precipitated by infection, surgery or
intercurrent disease
57. Management
• It is a medical emergency
• IV fluid (normal saline 1 L/h with continuous cardiac monitoring
and 10% dextrose)
• Hydrocortisone 100 mg bolus followed by 100–200 mg
hydrocortisone over 24 h infusion or i.v doses until GI symptoms
improve then start oral therapy
• Mineralocorticoid replacement can be initiated once the daily
hydrocortisone dose has been reduced to <50 mg
• Treat precipitating cause
58. Pheochromocytoma
•Is a are neuroendocrine tumor of the medulla of
the adrenal glands (originating in the chromaffin
cells), or extra-adrenal chromaffin tissue that
secretes excessive amounts of Catecholomines
(epinephrine and norepinephrine) --hormones
that regulate heart rate and bloodpressure
59. •May occur as a single tumor or as
more than one growth. It usually
develops in the center (medulla) of
one or both adrenal glands.
•Sometimes this kind of tumor occurs
outside the adrenal gland but 90% are
in the adrenal glands .The
extramedulary sites are;
•Within the sympathetic nervechain
along the spinal cord
•Overlying the distal aorta
•Within the ureter
•Within the urinary bladder
60. Factors associated with
pheochromocytoma include
•A family history of pheochromocytoma
•Tumors in other glands of the body
•Other hormonal disorders
•Genetic diseases including:
• Von Hippel-Lindau disease
• Multiple endocrine neoplasia type 2
• Neurofibromatosis type 1
• Paraganglioma syndromes
61. Pheo: Signs & Symptoms
• The five P’s:
• Pressure (HTN) 90%
• Pain (Headache)
• Perspiration
• Palpitation
• Pallor
80%
71%
64%
42%
• Paroxysms (the sixth P!)
• The Classical Triad:
• Pain (Headache), Perspiration, Palpitations
• Lack of all 3 virtually excluded diagnosis of pheo in a series of > 21,0000 patients
68. Prognosis
• •1/3 Patients continue to be hypertensive:
1)Not all tissue removed
2)Recurrence
3)Blood vessels damaged by severe & prolonged hypertension
•The tumors come back in less than 10% of these patients.
• Release of the hormones norepinephrine and epinephrine returns
to normal after surgery.
• Less than 50% of patients who have cancerous tumors that spread
to the bones, liver, or lung are alive after 5 years.
69. Assessments
• Blood sugar
- Hypoglycemia (after surgery)
- Hyperglycemia (before and during surgery)
• Blood pressure
- Hypertension (before and during surgery)
- Hypotension (after surgery)
71. People with primary Hyperaldosteronism have
a problem within the adrenal gland that causes
it to release too much aldosterone.
Primary Hyperaldosteronism
(Conn’s disease)
72. ⦁ Most cases are caused by a noncancerous
(benign) tumor of the adrenal gland.
⦁ Cases due to bilateral adrenal hyperplasia (The
enlargement of an organ caused by an increase in the
reproduction rate of its cells).
73. Secondary Hyperaldosteronism is when the
excess aldosterone is caused by something
outside the adrenal gland that mimics the
primary condition.
74. ⦁ May result from conditions that induce
hypertension through increased renin production,
ingestion of oral contraceptives, and pregnancy.
⦁ Conditions such as congestive heart failure, liver
failure, kidney disease, and dehydration, or
caused by certain medicines such as diuretics or
fludrocortisone.
⦁ It is likely that many cases of secondary
Hyperaldosteronism are never detected.
*Renin - An enzyme secreted by and stored in the kidney area that
stimulates aldosterone and therefore, raises blood pressure
75.
76. ⦁ Moderate hypertension, or high blood pressure
⦁ Similar symptoms of Primary Hyperaldosteronism
⦁ Most individuals have no other specific symptoms.
However, some may have:
◦ Muscle weakness
◦ Cramping
◦ Headaches
◦ Low potassium level
◦ Tingling
◦ Muscle spasms
◦ Fatigue
77. ⦁ Secondary Hyperaldosteronism is treated by
treating the underlying cause.
⦁ Typically medicines and diet (but not surgery)
are used to treat secondary Hyperaldosteronism.
⦁ Untreated Hyperaldosteronism can lead to
uncontrolled hypertension (can become a risk
factor for stroke or heart disease).
78. ⦁ Elevated aldosterone levels can be measured
in the blood or urine.
◦ A blood test, PRA (Plasma renin activity), is used to
distinguish between primary (low PRA) and
secondary Hyperaldosteronism (high PRA).
79. Virilization
• Virilization is a condition that causes a female to
develop male-pattern hair growth and other
masculine traits.
• Women with virilization often have an
imbalance in the sex hormones estrogen and
testosterone.
• Virilization is caused by an overproduction of
testosterone or use of anabolic steroids,
synthetic substances that act like the male
hormone testosterone.
80. Causes of Virilization
Any underlying medical condition that causes an imbalance in sex
hormone levels can result in virilization. These conditions are
likely to cause adrenal hyperplasia, an overproduction of
hormones in the adrenal cortex. In some cases, the
overproduction of adrenal hormones is caused by an adenoma
(cancerous tumour). This type of tumour is normally located
within the adrenal glands.
Other causes of virilization include:
•Use of male hormone supplements
•Use of steroids to increase muscle mass
•Development of ovarian cysts (normally seen in patients with
polycystic ovary syndrome)
81. Symptoms of Virilization
Women with this condition often experience male-
pattern baldness. They also tend to have an eruption of
acne on the chest, back, face, hairline, underarms and
groin.
Other symptoms of virilization include:
•Excessive facial hair (normally located on the cheeks, chin, and upper lip)
Deepening of the voice
Increased sex drive
Smaller than normal breasts
Enlarged clitoris
Irregular menstrual cycles
82. Diagnoses of Virilization
The blood sample will be tested for the presence of
testosterone, estrogen, progesterone, and other hormones.
If the level is very high, a dexamethasone suppression test
can help determine if the problem is coming from the adrenal
glands and whether the problem is an adenoma or adrenal
hyperplasia.
If cancerous adenoma is suspected, an imaging test, such as a
computed tomography (CT) scan will be performed to obtain
a view of the adrenal gland.
83. Treatments of Virilization
Removal of an adrenal gland that contains an adenoma is the
most common treatment for virilization. This is normally done
surgically. However, chemotherapy or radiation treatments will
be chosen if the tumour is in a dangerous area or is difficult to
reach. These therapies help shrink the growth before it’s
removed.
If a tumour is not the cause, an oral contraceptives will help
balance the hormone levels.
oral contraceptive will blocks testosterone production
completely.
The renin–angiotensin system (RAS), or renin–angiotensin–aldosterone system (RAAS), is a hormone system that regulates blood pressure and fluid and electrolyte balance, as well as systemic vascular resistance.[2]
When renal blood flow is reduced, juxtaglomerular cells in the kidneys convert the precursor prorenin (already present in the blood) into renin and secrete it directly into circulation. Plasma renin then carries out the conversion of angiotensinogen, released by the liver, to angiotensin I.[3] Angiotensin I is subsequently converted to angiotensin II by the angiotensin-converting enzyme (ACE) found on the surface of vascular endothelial cells, predominantly those of the lungs.[4] Angiotensin II is a potent vasoconstrictive peptide that causes blood vessels to narrow, resulting in increased blood pressure.[5] Angiotensin II also stimulates the secretion of the hormone aldosterone[5] from the adrenal cortex. Aldosterone causes the renal tubules to increase the reabsorption of sodium which in consequence causes the reabsorption of water into the blood, while at the same time causing the excretion of potassium (to maintain electrolyte balance). This increases the volume of extracellular fluid in the body, which also increases blood pressure.
If the RAS is abnormally active, blood pressure will be too high. There are several types of drugs which includes ACE inhibitors, ARBs, and renin inhibitors that interrupt different steps in this system to improve blood pressure. These drugs are one of the primary ways to control high blood pressure, heart failure, kidney failure, and harmful effects of diabetes.[6][7]
Causing hyperglycemia, by stimulating the liver to make more glycogen stores which eventually fill up and tell the liver to make more glucose (gluconeogenesis), increase the protein breakdown and actually induces insulin resistant as well as increasing fat deposition, all this will either result in too much glucose in the liver which eventually will be shunted into circulation or because of the insulin resistant will cause the inability of glucose to be taken up by cells thus leading to hyperglycemia.
Also increase BP and suppresses the immune system which help decrease pains sensation but at the same time it will increase the risk of infection and this is because the immune cells are being suppressed and thus are unable to defenf the body
Stimulate osteoclast activity in the bone leading to osteopenia and increasing the risk of osteoporosis thus increasing the risk of bone fracture
Causing hyperglycemia, by stimulating the liver to make more glycogen stores which eventually fill up and tell the liver to make more glucose (gluconeogenesis), increase the protein breakdown and actually induces insulin resistant as well as increasing fat deposition, all this will either result in too much glucose in the liver which eventually will be shunted into circulation or because of the insulin resistant will cause the inability of glucose to be taken up by cells thus leading to hyperglycemia.
Also increase BP and suppresses the immune system which help decrease pains sensation but at the same time it will increase the risk of infection and this is because the immune cells are being suppressed and thus are unable to defenf the body
Stimulate osteoclast activity in the bone leading to osteopenia and increasing the risk of osteoporosis thus increasing the risk of bone fracture
Have minimal role in stress and . Androgen actually promote prostate growth in men and help with the development of masculine characteristic such as deep voice and hair growth.
In females, androgens adrenal are important in libido and thus a decrease in androgen production will result in a decrease in libido decrease in sexual drive in females