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

Jan 04, 2016

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Page 1: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

PATHOPHYSIOLOGY OF ADRENOCORTICAL HORMONE

Dr. Amel Eassawi

Page 2: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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.

Page 3: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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PATHOPHYSIOLOGY

Adrenocortical hormones

Hyper secretion

Aldosterone

Conn’sSec.Hyper

Aldosteronism

Cortisol

Cushing’ssyndrome

DHEA

AdrenogenitalSyndrome

Hyposecretion

Addison’sDisease

Page 4: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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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.

Page 5: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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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)

Page 6: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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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

Page 7: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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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

Page 8: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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CUSHING’S SYNDROME

Page 9: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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CUSHING’S SYNDROME

AfterBefore

Page 10: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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CLINICAL FEATURES OF CUSHING'S SYNDROME

Page 11: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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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

Page 12: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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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

Page 13: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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Hormonal interrelationships in adrenogenital syndrome

Page 14: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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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)

Page 15: Dr. Amel Eassawi. At the end of this lecture the student should be able to:  Describe Pathophysiology of hypo and hyperpadrenalism.  Correlate the features.

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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