Pathophysiology of adrenocortical hormone
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PATHOPHYSIOLOGY OF ADRENOCORTICAL HORMONE. Dr. Amel Eassawi. Objectives. At the end of this lecture the student should be able to: Describe Pathophysiology of hypo and hyperpadrenalism .

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Pathophysiology of adrenocortical hormone

PATHOPHYSIOLOGY OF ADRENOCORTICAL HORMONE

Dr. AmelEassawi


Objectives
Objectives

At 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.



Pathophysiology1
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.


Hyperaldosteronism
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)


Cushing s syndrome
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


Cushing s syndrome1
CUSHING’S SYNDROME

  • Features

    • High blood glucose

    • Glucosuria – Adrenal diabetes

    • Protein shortage

    • Buffalo hump

    • Moon face

    • Thin extremities, weakness & fatigue

    • Reddish – purple linear stria



Cushing s syndrome3
CUSHING’S SYNDROME

Before

After



Adrenal androgen hypersecretion
ADRENAL ANDROGEN HYPERSECRETION

  • Adrenogenital syndrome

  • In adult females

    • Male pattern of body hair

    • Deep voice

    • Muscular arms & leg

    • Decrease breast size, menstrual suppression


Adrenal androgen hypersecretion1
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



Adrenocortical insufficiency
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
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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