PATHOPHYSIOLOGY OF ADRENOCORTICAL HORMONE
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Transcript of PATHOPHYSIOLOGY OF ADRENOCORTICAL HORMONE
PATHOPHYSIOLOGY OF ADRENOCORTICAL HORMONE
Dr. Amel Eassawi
OBJECTIVESAt the end of this lecture the student should be able to: Describe Pathophysiology of hypo and hyperpadrenalism. Correlate the features of hypo and hyper adrenalism with
the physiological action and control mechanism of adrenocortical hormones.
Describe the different stress mechanisms and the body’s response to these stressors.
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PATHOPHYSIOLOGY
Adrenocortical hormones
Hyper secretion
Aldosterone
Conn’sSec.Hyper
Aldosteronism
Cortisol
Cushing’ssyndrome
DHEA
AdrenogenitalSyndrome
Hyposecretion
Addison’sDisease
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PATHOPHYSIOLOGY
• Primary hyperaldosteronism, or Conn’s syndrome)-Adrenal tumor.
• Secondary hyperaldosteronism- inappropriately high activity of the renin-angiotensin-aldosterone system.
• Cortisol hypersecretion - (Cushing’s syndrome).• Adrenal androgen hypersecretion – adrenogenital
syndrome.
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HYPERALDOSTERONISM• Primary hyperaldosteronism, or Conn’s syndrome
– Cause:• Adrenal tumor of aldosterone –secreting cells
• Secondary hyperaldosteronism– Cause:
• inappropriately high activity of the renin-angiotensin-aldosterone system.
Symptoms:• excessive Na+ retention (hypernatremia) and • K +depletion (hypokalemia). • high blood pressure (hypertension)
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CUSHING’S SYNDROME
• Cause– Overstimulation of the adrenal cortex by excessive
amounts of CRH and/or ACTH,– Adrenal tumors that uncontrollably secrete
cortisol independent of ACTH, – ACTH-secreting tumors located in places other
than the pituitary, most commonly in the lung
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CUSHING’S SYNDROME
• Features– High blood glucose– Glucosuria – Adrenal diabetes– Protein shortage– Buffalo hump– Moon face– Thin extremities, weakness & fatigue– Reddish – purple linear stria
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CUSHING’S SYNDROME
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CUSHING’S SYNDROME
AfterBefore
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CLINICAL FEATURES OF CUSHING'S SYNDROME
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ADRENAL ANDROGEN HYPERSECRETION
• Adrenogenital syndrome• In adult females
– Male pattern of body hair– Deep voice– Muscular arms & leg– Decrease breast size, menstrual suppression
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ADRENAL ANDROGEN HYPERSECRETION
• Adrenogenital syndrome• In newborn females
– Male type of external genitalia– female pseudohermaphroditism
• In pubertal males– prematurely develop male secondary sexual characteristics– precocious pseudopuberty
• In adult males– No apparent effect
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Hormonal interrelationships in adrenogenital syndrome
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ADRENOCORTICAL INSUFFICIENCY• Primary adrenocortical insufficiency, also known as Addison’s
disease– Autoimmune destruction of cortex
• Features are related to Aldosterone deficiency– K+ retention (hyperkalemia), – Na+ depletion (hyponatremia), – disturbed cardiac rhythm.– Hypotension
• Features are related to cortisol deficiency– poor response to stress, – hypoglycemia (low blood glucose)– hyperpigmentation (darkening of the skin)
References
Human physiology, Lauralee Sherwood, seventh edition.
Text book physiology by Guyton &Hall,11th edition.
Text book of physiology by Linda .S .Costanzo third edition
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