NR283 IPathophysiology IExam I3 IReview
Chapter I19 I Alterations Iof IHormonal I Regulation
- Addison’s Idisease I – I (A drenal I Insufficiency)-
- - I I A uto immune I diso rder I w here I body I creat es I antigens It hat I att ack I the I adrenal I glands
- - Idecrease I in I ho rmones Iin I adrenal I co rtex I such I as I co rtico stero id I and
I mineralo co rt icoid Isynthesis I and Ielevated I levels I of IA CTH I (loss I of Inegat ive I feedback).
- -Mo re I t hen I 90% I o f I adreno co rt ical I t issue I is I dest ro yed I causing I clinical I manifest atio ns.
- - I No I adrenal I glands I wo rking I resulting I in I hypo co rtiso lism I (lo w I levels Iof I co rt iso l)
I andIh ypo aldost eronism
- - I Clinical I M anifest at io ns: I Weakness, I fatigue I hypo tensio n, I hyperkalemia I (^K),
I hypo glycemia,Ie levated IA CTH, Iskin Ichanges I(hyperpigment ation I and I vit iligo) I may Ioccur
- Cushings ISyndrome- I caused I by Ichro nic Iexpo sure It o Iexcess Ico rtiso l I (t oo I much I st eroid).
- Co rtical I hyperfunctio n I (hyperco rt iso lism) I – ID OES I NOT I invo lve I the I pit uit ary I gland.
- Hypo kale mia I(decrease IK), Iincrease Iin INa+ Iresulting Iin I^BP, Ihyperglyce mia,
Imet abo lic Ia lka lo sis I (decrease I H+)
- Weight I gain I is I the I mo st I co mmo n I feature I and I result s I fro m I the I accumulation I o f I adipose
Itissue I in It he It runk, Ifacial, I and I cervical I areas I (t runcal I obesit y, I moon I face, I and I buffalo Ihump)
- Glucose I int o lerance I o ccurs I because I o f I co rtiso l-induced I insulin I resist ance I and
I increased Igluco neo genesis Iand Iglyco gen Ist o rage I by It he Iliver.
, - caused I by
Ieither
Iexcessive
Icortiso l-
likeImedicat
ionIs uch
as
Ipredniso ne Io r
a Itumo r It hat
Ieither
Ipro duces Io r
Iresults I in
Ithe Iproductio
n IofIexcessive
Ico rtiso l Iby
Ithe I adrenal
Iglands.
- Cases I due It o I a I pituit ary I adeno ma I are I kno wn I as ICushing's Idisease.
Acromegaly- I Hypersecretion I of I Growth I Hormone-
o A I d isord er Iin I ad u lts I in I wh ich Ithe I p itu it ary Igland Ipro duces Itoo I much Igr owth Ihor mon e
- Resu lts I fro m Icon tinuous Ie xpo sure Ito Ih igh Ile ve ls Io f I gro wth Ihor mon e I (GH) I and Iinsu lin -like I gro wth I factor
I1 I (IGF-1); Iit Ial mo st Ialways Iis Ic au se d Ib y Ia IGH Isec re t in g Ip itu it ar y Iad e no ma.
Alterations Ii nIAdrenal IFunction
-
Pheochromocytoma I- IChromaffin Icell ITumors
- A Ihor mone -secret ing I tu mor I (ben ign) I th at Ican Ioccur I in I the I adren al I glands I (neuro endocr ine Itu mo r
I of Ith e I medu lla Io f Ith e Iadren al I glands).
- adr en al I gland I r ele ases I hor mone s I th at I cau se I per siste nt I or I ep iso dic I high I b loo d I pre ssur e,
I head ache s, Id iap horesis, Ip alp it atio ns
- Symp at het ic I p ar aganglio mas I cau se I e xcessive I p roduct ion I of I nore pineph rine I and I e pinephr in e.
- Tu mor I re le ases I catecho lamine I (Ep i I & I N E) I e pisod ically I so I sympto ms I occur I in I paro xysmal I (co me I and I go )
- Catecho lamine Ib re akdo wn It o I met ab olit es I th at I ar e Itested I in Iur in e:
- VM A I & IHVA Ithe I VM A I wit h I be Iincreased .
Chapter I19 I Alterations Iof IHormonal I Regulation
- Addison’s Idisease I – I (A drenal I Insufficiency)-
- - I I A uto immune I diso rder I w here I body I creat es I antigens It hat I att ack I the I adrenal I glands
- - Idecrease I in I ho rmones Iin I adrenal I co rtex I such I as I co rtico stero id I and
I mineralo co rt icoid Isynthesis I and Ielevated I levels I of IA CTH I (loss I of Inegat ive I feedback).
- -Mo re I t hen I 90% I o f I adreno co rt ical I t issue I is I dest ro yed I causing I clinical I manifest atio ns.
- - I No I adrenal I glands I wo rking I resulting I in I hypo co rtiso lism I (lo w I levels Iof I co rt iso l)
I andIh ypo aldost eronism
- - I Clinical I M anifest at io ns: I Weakness, I fatigue I hypo tensio n, I hyperkalemia I (^K),
I hypo glycemia,Ie levated IA CTH, Iskin Ichanges I(hyperpigment ation I and I vit iligo) I may Ioccur
- Cushings ISyndrome- I caused I by Ichro nic Iexpo sure It o Iexcess Ico rtiso l I (t oo I much I st eroid).
- Co rtical I hyperfunctio n I (hyperco rt iso lism) I – ID OES I NOT I invo lve I the I pit uit ary I gland.
- Hypo kale mia I(decrease IK), Iincrease Iin INa+ Iresulting Iin I^BP, Ihyperglyce mia,
Imet abo lic Ia lka lo sis I (decrease I H+)
- Weight I gain I is I the I mo st I co mmo n I feature I and I result s I fro m I the I accumulation I o f I adipose
Itissue I in It he It runk, Ifacial, I and I cervical I areas I (t runcal I obesit y, I moon I face, I and I buffalo Ihump)
- Glucose I int o lerance I o ccurs I because I o f I co rtiso l-induced I insulin I resist ance I and
I increased Igluco neo genesis Iand Iglyco gen Ist o rage I by It he Iliver.
, - caused I by
Ieither
Iexcessive
Icortiso l-
likeImedicat
ionIs uch
as
Ipredniso ne Io r
a Itumo r It hat
Ieither
Ipro duces Io r
Iresults I in
Ithe Iproductio
n IofIexcessive
Ico rtiso l Iby
Ithe I adrenal
Iglands.
- Cases I due It o I a I pituit ary I adeno ma I are I kno wn I as ICushing's Idisease.
Acromegaly- I Hypersecretion I of I Growth I Hormone-
o A I d isord er Iin I ad u lts I in I wh ich Ithe I p itu it ary Igland Ipro duces Itoo I much Igr owth Ihor mon e
- Resu lts I fro m Icon tinuous Ie xpo sure Ito Ih igh Ile ve ls Io f I gro wth Ihor mon e I (GH) I and Iinsu lin -like I gro wth I factor
I1 I (IGF-1); Iit Ial mo st Ialways Iis Ic au se d Ib y Ia IGH Isec re t in g Ip itu it ar y Iad e no ma.
Alterations Ii nIAdrenal IFunction
-
Pheochromocytoma I- IChromaffin Icell ITumors
- A Ihor mone -secret ing I tu mor I (ben ign) I th at Ican Ioccur I in I the I adren al I glands I (neuro endocr ine Itu mo r
I of Ith e I medu lla Io f Ith e Iadren al I glands).
- adr en al I gland I r ele ases I hor mone s I th at I cau se I per siste nt I or I ep iso dic I high I b loo d I pre ssur e,
I head ache s, Id iap horesis, Ip alp it atio ns
- Symp at het ic I p ar aganglio mas I cau se I e xcessive I p roduct ion I of I nore pineph rine I and I e pinephr in e.
- Tu mor I re le ases I catecho lamine I (Ep i I & I N E) I e pisod ically I so I sympto ms I occur I in I paro xysmal I (co me I and I go )
- Catecho lamine Ib re akdo wn It o I met ab olit es I th at I ar e Itested I in Iur in e:
- VM A I & IHVA Ithe I VM A I wit h I be Iincreased .
