Aims:
Aims Normal Physiology Conn Syndrome Addison Disease Cushing’s CAH Phaeochromocytoma
Normal Physiology :
Normal Physiology Cortex Zona Glomerulosa A ldosterone Zona Fasciculata Cortisol Zona Reticularis Androgens Medulla Adrenaline/ noradrenaline Image taken from http://genericlook.com/anatomy/Adrenal-Gland/
Conn Syndrome:
Conn Syndrome Excess - Tumour Features - Hypokalemic Hypertension Investigations Assess renin angiotensin system High Ald:Renin ratio CT/MRI Treatment Medical Vs Surgical
Addison Disease:
Addison Disease Lack of – ‘HAT’ Features – Postural hypotension, dehydration, Tired Investigations Synacthen Test Low Na, High K, Low Glucose Treatment 5 S’s
Cushing’s:
Cushing’s Disease Vs Syndrome ACTH Dependant Vs Independent Features Investigations 24 Hr urinary free cortisol Dexamethasone Test Low dose (Defines) High dose (Locates ) Treatment - Surgical Image taken from http://animalpetdoctor.homestead.com/cushings.html
Congenital Adrenal Hyperplasia:
Congenital Adrenal Hyperplasia Congenital Enzyme defect 21 Hydroxylase deficiency Features ACTH and Androgen Excess Mineralcorticoid and Glucocorticoid deficiency Investigations 17 OH progesterone raised Treatment – replacement therapy
Phaeochromocytoma:
Phaeochromocytoma Excess Adrenaline Feature Headache, Palpatations , HTN, Stroke, AF, Investigations 24 Hr Urinary adrenaline collection Abdo CT/MRI Treatment Phenoxybenzamine (Alpha Blocker) Surgical
Disclaimer:
Disclaimer This lecture is intended to act as a revision tool It is not intended to Act as a patient educational tool Replace lectures in medical schools