Adrenal Diseases: Clinical Overview and Management. Deepika Reddy, March 7, :30 AM Department of Endocrinology

Size: px
Start display at page:

Download "Adrenal Diseases: Clinical Overview and Management. Deepika Reddy, March 7, :30 AM Department of Endocrinology"

Transcription

1 AdrenalDiseases:Clinical OverviewandManagement DeepikaReddy,March7, :30AM DepartmentofEndocrinology

2 ObjecFves Understandbasicadrenalphysiology (steroidogenesis) UnderstandthefuncFonofvariousadrenal hormones Reviewcommonformsofcongenitaladrenal hyperplasia Reviewhormonaldeficiencyandhormonal excessstates.

3 HistologyoftheAdrenalGland

4 TheAdrenalGland OuterZoneofCortex:Glomerulosa Siteofaldosterone(mineralocorFcoid)producFon MiddleZoneofCortex:Fasciculata SiteofcorFsol(glucocorFcoid)producFon InnerZoneofCortex:ReFcularis SiteofandrogenproducFon AdrenalMedulla siteofcatecholamineproducfon

5 FuncFonofAdrenalHormones Aldosterone EffectisonrenalcollecFngtubuleandpartofthe distalconvolutedtubule.itservestoincrease sodium,waterreabsorpfonandpotassium excrefon. Aldosteroneisthereforeinvolvedinmaintenance ofextracellularfluidvolume,naandk concentrafon AcFvatedbytherenin angiotensinsystem

6 GlucocorFcoidFuncFon Figfrom Endocrinologyanintegratedapproach :S.S.NusseyandS.A.Whitehead

7 GlucocorFcoidFuncFon Liver:Raisebloodglucose:ByincreasinghepaFcglucoseproducFonandreduced peripheraluflizafon Muscle:Aminoacidreleasefrommuscleforgluconeogenesis,chronicusecauses musclewasfng AdiposeTissue:Lipolysis,o`encounteredbythelipogenesisinducedbyinsulin Bone:DecreasedosteoblastaciFvity,increasedosteoclastacFvity,decreased calciumabsorpfonfromgutanddecreasedresponsivenesstovitamind ImmuneSystem:AnF inflammatoryproperfes/immunesuppressionbymulfple mechanisms Skin:affectsfibroblastfuncFon Cardiovascular:potenFatestheaffectofcatecholaminesandAngiotensinIIonthe vasculature. CNS:maybeassociatedwithdepression,psychosis Kidney:IncreasesrenalbloodflowandincreasesGFR. (InhighconcentraFons,canhavemineralocorFcoideffect)

8 AdrenalAndrogens Playasignificantroleingonadaldevelopmentinuteroand youngchildren. Inadultmales,adrenalglandnotasignificantsourceof androgens Inadultfemales,adrenalandrogenexcesscancause symptomsofandrogenexcesssuchashirsuifsm.deficiency maycauselossofsomesecondarysexualcharacterisfcs.in thepostmenopausalstatemaybeanimportantsourceof androgens.

9 Effectsofcatecholamines Cardiovascular Increase in heart rate and force Increased venous return Increased peripheral resistance Visceral Smooth muscle relaxation via β 2 actions and contraction via α mediated actions Modulation of fluid and electrolyte transport in the gut, kidney, gall bladder via α receptors Metabolic β receptor mediated glycogenolysis, lipolysis Increases in diet induced and non shivering thermogenesis via β receptors Water and electrolyte metabolism Decreased sodium excretion and glomerular filtration due to direct effects on the kidney β receptor mediated effects on renin secretion leads to increased aldosterone production with effects on distal sodium handling Serum potassium may be increased as a result of α mediated effects on the liver but decreased as a result of β 2 receptormediated effects on muscle Hormone secretion The sympatho adrenal part of the autonomic nervous system modulates the responses of a number of endocrine systems, including: The renin angiotensin aldosterone system Increased secretion of glucagon and insulin

10 ADRENAL STEROID PRODUCTION 1 : 17 hydroxylase (CYP17, P450c17); 17,20: 17,20 lyase (also mediated by CYP17); 3 : 3 hydroxysteroid dehydrogenase; 21: 21 hydroxylase (CYP21A2, P450c21); 11 : 11 hydroxylase; (CYP11B1, P450c11); 18 refers to the two step process of aldosterone synthase (CYP11B2, P450c11as), resulting in the addition of an hydroxyl group that is then oxidized to an aldehyde group at the 18 carbon position; 17 R: 17 reductase; 5 R: 5 reductase; DHEA: dehydroepiandrostenedione; DHEAS: DHEA sulfate; A: aromatase (CYP19). Source: UPTODATE

11 Case1 A26 year oldwomanwasreferredbecauseofincreasingfacialhair.she hadhermenarcheat11yearsofagebuthadalwaysnotedirregular periods.shewas154cmtallwithaweightof87kg.onexaminafon,she wasobesebuthadnoclinicalevidenceofglucocorfcoidor mineralocorfcoidexcessandherbloodpressurewasnormal.shehad, however,excessfacialhair,areolarhairsonthebreasts,malepagern pubichairwithanextensionupthelineaalbainthemidlineofthelower abdomen.therewashairontheinnerthighsbutnoneonherback.there wasnoclitoralhypertrophy,breastatrophyorothersignsof masculinizafonsuchasdeepvoiceandmusculardevelopment. Herserumtestosteronewasmildlyelevatedaswasher17OH progesteronelevel.therewasasignificantincreasein17ohprogestrone levelfollowingacthsfmulafon

12 CongenitalAdrenalHyperplasia(CAH):duetoCYP21A2 Deficiencyofanyoftheenzymesintheadrenalsteroidsynthesispathway cancausespecificclinicaldisorders ThemostcommonisCYP21A2(21hydroxylase)deficiency.Itisassociated with: ImpairedsynthesisofcorFsol impairedsynthesisofaldosterone IncreasedACTHandincreasedprecursorhormones.Asaconsequence thereisincreasedandrogenproducfonthatcancausevirilizafon. ItmaybeseenininfancywithoutorwithoutsaltwasFng. MayalsobepickedupfirstinadultswithahistoryofhirsuiFsm,o`en inferflity,possiblecliteromegaly TreatwithglucocorFcoids

13 ADRENAL STEROID PRODUCTION 1 : 17 hydroxylase (CYP17, P450c17); 17,20: 17,20 lyase (also mediated by CYP17); 3 : 3 hydroxysteroid dehydrogenase; 21: 21 hydroxylase (CYP21A2, P450c21); 11 : 11 hydroxylase; (CYP11B1, P450c11); 18 refers to the two step process of aldosterone synthase (CYP11B2, P450c11as), resulting in the addition of an hydroxyl group that is then oxidized to an aldehyde group at the 18 carbon position; 17 R: 17 reductase; 5 R: 5 reductase; DHEA: dehydroepiandrostenedione; DHEAS: DHEA sulfate; A: aromatase (CYP19). Source: UPTODATE

14 CAHduetoCYP17deficiency MostpaFentspresentatabouttheFmeofexpectedpubertybecauseof hypertension,hypokalemia,andhypogonadism. Theremayormaynotbeadrenalinsufficiency,dependinguponthe degreeofthecorfsolsecretorydefect. FemalepaFents Female(46,XX)paFentshaveprimaryamenorrheaand absentsecondarysexualcharacterisfcs. MalepaFents Male(46,XY)paFentsusuallyhavecompletemale pseudohermaphrodifsm,withfemaleexternalgenitalia,ablindvagina,no uterusorfallopiantubes,andintraabdominaltestes. Source:UPTODATE

15 CAHfrom3 BETA HYDROXYSTEROIDDEHYDROGENASE deficiency MostpaFentspresentasneonatesorinearlyinfancywithclinical manifestafonsofbothcorfsolandaldosteronedeficiency. TheyhavewithfeedingdifficulFes,vomiFng,volumedepleFon, hyponatremia,andhyperkalemia. FemalesmayhavemildvirilizaFonoftheirexternalgenitalia,presumably duetoexcessdhea,aligleofwhichisconvertedperipherallyto testosterone. Maleshavevaryingdegreesoffailureofnormalgenitaldevelopment, rangingfromhypospadiastomalepseudohermaphrodifsmwithnearly normalfemaleexternalgenitalia.

16 Case2 A33 year oldwomanpresentedwithincreasingskin pigmentafonandweightloss.shealsohadnauseaand abdominaldiscomfort.therewasnoobtainablefamilyhistory ofanyillnessand,apartfromlethargy,shedeniedanyother problem.shehadtwohealthychildren.shewastakingno medicafon.shehadasupinesystolicbloodpressureof50 mmhg(thatbecameunrecordablewhenstanding) HerbaselinecorFsollevelat8AMwas3mcg/dL.Shewas given250mcgofcosyntropin.corfsolrecheckedat30min was7mcg/dlandat60minwas9mcg/dl.

17 ClinicalfeaturesofAdrenalInsufficiency Weakness FaFgue Anorexia Weightloss HyperpigmentaFon Hypotensionandposturalsymptoms,shockacute. Nausea/vomiFng SaltCraving

18 EFology:PrimaryvsSeondary AnACTHsFmulaFontestisusedtodiagnoseadrenalinsufficiency BaselinecorFsolandACTHchecked.FollowingthisthepaFentreceives 250mcgofcosyntropin.CorFsollevelsarerechecked30minand60min later.thetestisadequateifeitherthe30minor60minlevelis18 20 mcg/dlorgreater. Iftheresponseisinadequate,theACTHlevelhelpsdetermineifitis primaryadrenalorsecondarytopituitarydysfuncfon. AhighACTHsuggestsprimaryadrenalinsufficiencyandalowACTHlevel suggestssecondaryadrenalinsufficiency.

19 CausesofPrimaryAdrenalInsufficiency Autoimmune MetastaFcmalignancy Adrenalhemorrage InfecFonssuchasTB Adrenoleukodystrophy InfilteraFvedisorderssuchasamyloidosis CongenFaladrenalhyperplasia FamilialglucocorFcoiddeficiency(unresponsivetoACTH) Drugssuchasketoconazole,mitotane,etomadateetc.

20 CausesofSecondaryAdrenalInsufficiency ExogenousSteroids PituitaryDysfuncFon/Hypothalamic dysfuncfon TumorcompressingcorFcotrophs Bleed(Sheehans) Immune(LymphocyFchypophysiFs) Hemochromatosis InfiltaraFve(sarcoidosis)

21 TreatmentofAdrenalInsufiiciency InPrimaryAdrenalInsufficiency ReplaceGlucocorFcoidandPossibly MineralocorFcoid InSecondaryAdrenalInsufficiency ReplaceGlucocorFcoid InformallpaFentsof sickdayrules Takex2 3 Fmesmaintenancedoseinacuteillness.

22 Case3 A25yearoldfemalepaFentwaspresented with50lbweightgainover1year.shehad fafgue,hirsuifsmandincreasingabdominal striae.shealsousedtohaveregularperiods unflabouttwoyearsagowhenthecycles becomeirregular. A24hrurinefreecorFsolwasx5theupper limitofnormalrange

23 ClinicalFeaturesofcorFsolexcess(Cushing ssyndrome inthiscase) Obesity Hypertension HirsuFsm Striae Acne EasyBruising Osteopenia MuscleWeakness Depression(someFmespsychosis) Menstrualdisorders Glucoseintolerance ElevatedLipids Kidneystones

24 EFologyofCushing ssyndrome Adrenalhyperplasia.CanbeduetoACTH oversfmulafon.acthcanbefromanectopic sourcesuchassmallcelllungcancer. WhentheACTHcomesfromthepituitarythat iscushing sdisease Adrenaladenomas Adrenalcarcinomas Iatrogenic

25 IniFalDiagnosis IfCorFsolexcessissuspected,thefollowingtestcanbedone 24hrurinefreecorFsolvaluesoverx4theupperlimitofnormalare thoughttobesignificant. Suppresionwith1mgdexamethasone.At11PM,1mgof dexamethasoneisgivenandcorfsolischeckedat8am.innormal pafents,thecorfsolsuppressesbelow1.8mcg/dl.falseposifvemay beseeninpafentsonanfseizuremedicafonandinrenalfailure. MidnightsalivarycorFsol.ThereisdiurnalvariaFonincorFsol release.pafentswithcushingslosethisvariafon.salivarycorfsolis checkedonthreeconsecufvedays.posifveifthemajorityare abnormal.thistestmayalsohelpdisfnguishcushing sfrompseudo cushing sdisease.

26 IniFalDiagnosis ThenextstepistoassessACTHlevels WhenthecorFsolexcessisduetoprimary adrenalover producfon(eg.adrenal Adenoma),ACTHlevelsarelow. IfACTHlevelsarehigh,thesourceiseitherthe pituitaryorotherfssue(ectopicsource)

27 Treatment SurgeryistheprimarytreatmentforCushing s Syndrome IfthepaFentisnotacandidateforsurgery/ hasextensivediseasedrugsthatblockadrenal steroidsynthesissuchasmetyrapone, ketoconazolecanbetried.

28 EndocrineReasonsforHypertension AdrenalDependent Pheochromocytoma Primaryaldosteronism CushingsSyndrome HyperdeoxycorFcosteronism CongenitalAdrenalHyperplasia 11b hydroxylasedeficiency 17a hydroxylasedeficiency Deoxycortocosterone producingtumor Source:Endocrinehypertension:WilliamYoungfromCleveland ClinicEndocrinereview

29 Pheochromocytomas: Pheochromocytomasaretumorsofneuroectodermalorigin TheyresultinincreasedcatecholamineproducFono`enfromtheadrenal medulla 2 8cases/million Male:FemaleraFois1:1 Usuallypresentsin3 5 th decadeoflife CLINICALMANIFESTATIONS HTNin90 100%o`enlabile ParoxysmalepisodesincludeClassicTriad:Headache,sweaFngand palpitafons ChronicvolumedepleFon Cardiomyopathy/MI Source:WilliamsTextbookofEndocrinology.10thediFonpg555

30 SynthesisofCatecholamines

31 MetabolismofCatecholamines

32 DiagnosisofPheochromocytoma 24hrUrineStudies: Urinemetanephrinesandcatecholaminesaremostreliabletestfor pheochromocytoma Ifsuspicionishighurinefreemetanephrinesmaybeuseful CheckcreaFninewiththeurinestudiestoensureadequacyofthesample PlasmaStudies: FracFonatedplasmafreemetanephrinesmaybeused:HighpredicFvevalueofa negafvetest

33 LocalizaFonofthePheochromocytoma Sporadicpheochromocytomasarelarge(o`en 2 5cm)ThoseassociatedgeneFcsyndromes canbesmaller. 95%areintraabdominal 90%withintheadrenalgland CTorMRIcanbeusedforiniFalevaluaFon. MIBGscan(sensiFvity80%,specificity99%) canbeconfirmatory. UseMRIinpregnantwomen

34 ManagementofpaFentswith Pheochromocytoma PaFentsneedtohaveadrenergicblockade7 10dayspriorto surgery.sooneriftheyhavehadrecentmiorcardiomyopathy Canstartwithalphablocker.Phenoxybenzamineisusedstart at10mgandraiseq2 3daysFllSBParound100./warn pafentaboutorthostasisandfafgue. Mayalsousecalciumchannelblocker/nicardipine30mgBID DONOTuseonlybetablockersmaymakecondiFonsworse duetounopposedalphaadrenergicsfmulafon Onceadequatelyblocked,paFentcanhavePheoresected.

35 Ruleof10withPheochromocytomas 10%areextraadrenal 10%occurinchildren 10%aremulFple 10%recura`ersurgicalremoval.PaFentsshouldhavetesFng yearlyfollowingsurgery 10%aremalignant 10%arefamilial(orpartofsyndromesuchasMEN) Mayneedscreeningforthesesyndromes. 10%arefoundasadrenalincidentalomas

36 PrimaryAldosteronism DuetooverproducFonofaldosteroneinthezona glomerulosa PaFentspresentwithhypertensionando`enhave hypokalemia. MayalsohavenonspecificfindingssuchasfaFgue, headaches,increasedthirst. Maybduetoadrenaladenomaorhyperplasia

37 Diagnosis MeasureserumaldosteroneandplasmareninacFvityinAM SuggesFveifaldosterone/PRAacFvityisgreaterthan30ANDtheabsolute aldoteroneofgreaterthan15ng/dl. ConfirmwithSaltloadingtests(canuseeitheroralorIV.UsewithcauFonin pafentswithseverehypertensionandchf) Oralsaltloading,andadequatepotassiumreplacementfor3days. Thendo24hrurineforaldosterone.Normalvaluesare5 20mcgin24hours CanalsodoIVsalineloading(2litersover4hours.CheckcorFsoland aldosteronebeforeanda`ertheload.postsalinerafoofaldosteroneto corfsolgreaterthan3seenwithaldosteroneproducingadenoma.

38 LocalizaFon CTorMRIcanbeusedasiniFalstudy Canconfirmwithadrenalveinsampling. Rightandle`adrenalveinandvenacavacorFsoland aldosteronemeasured Catheterplacementisaccurateiftheadrenalveinto venacavacorfsolrafois5:1. Aldosteronelevelsfromle`andrightadrenalveins arecomparedandgreaterthan4:1rafobetween thetwosuggestunilateralaldosteoneproducing adenoma.

39 Treatment Dependsondiagnosis Ifanadenomaisdetected,treatmentissurgery. ShouldbepreppedpreoperaFvelywithspironolactone Bloodpressureandpotassiumarenormal. Ifduetohyperplasia,treatedwithanFhypertensives specificallyaldosteroneantogonists(spironolactone, eplerenone)

Adrenal gland And Pancreas

Adrenal gland And Pancreas Adrenal gland And Pancreas Structure Cortex Glucocorticoids Effects Control of secretion Mineralocorticoids Effects Control of secretion Sex steroids Medulla Catecholamines Adrenal cortex 80% of an adrenal

More information

CPY 605 ADVANCED ENDOCRINOLOGY

CPY 605 ADVANCED ENDOCRINOLOGY CPY 605 ADVANCED ENDOCRINOLOGY THE ADRENAL CORTEX PRESENTED BY WAINDIM NYIAMBAM YVONNE HS09A187 INTRODUCTION Two adrenal glands lie on top of each kidney. Each gland between 6 and 8g in weight is composed

More information

74. Hormone synthesis in the adrenal cortex. The glucocorticoids: biosynthesis, regulation, effects. Adrenal cortex is vital for life!

74. Hormone synthesis in the adrenal cortex. The glucocorticoids: biosynthesis, regulation, effects. Adrenal cortex is vital for life! 74. Hormone synthesis in the adrenal cortex. The glucocorticoids: biosynthesis, regulation, effects. Adrenal cortex is vital for life! 5 g each Zona glomerulosa : Mineralocorticoids ALDOSTERON Zona fasciculata:

More information

Assistant Professor of Endocrinology

Assistant Professor of Endocrinology Pathophysiology Of Adrenal Disorder Dr.Rezvan Salehidoost Assistant Professor of Endocrinology Pathophysiology Of Adrenal Disorder The adrenal glands lie at the superior pole of each kidney and are composed

More information

ADRENAL GLAND. Introduction 4/21/2009. Among most important and vital endocrine organ. Small bilateral yellowish retroperitoneal organ

ADRENAL GLAND. Introduction 4/21/2009. Among most important and vital endocrine organ. Small bilateral yellowish retroperitoneal organ Introduction Among most important and vital endocrine organ ADRENAL GLAND D.Hammoudi.MD Small bilateral yellowish retroperitoneal organ Lies just above kidney in gerota s fascia 2 1 The Adrenal Gland Anatomy

More information

ComprehensivePLUS Hormone Profile with hgh

ComprehensivePLUS Hormone Profile with hgh OLEBound400: 801 SW 16th St Suite 126 Renton WA 98057 425.271.8689 425.271.8674 (Fax) ComprehensivePLUS Hormone Profile with hgh Doctor ID Patient Name 6206 Doe, Jane Age Sex Date of Birth 44 F Date Collected

More information

Aldosterone synthase inhibitors. John McMurray BHF Cardiovascular Research Centre University of Glasgow

Aldosterone synthase inhibitors. John McMurray BHF Cardiovascular Research Centre University of Glasgow Aldosterone synthase inhibitors John McMurray BHF Cardiovascular Research Centre University of Glasgow Inhibition of aldosterone synthesis is hypothesized to be of benefit to patients with cardiovascular

More information

Mineralocorticoids: aldosterone Angiotensin II/renin regulation by sympathetic tone; High potassium will stimulate and ACTH Increase in aldosterone

Mineralocorticoids: aldosterone Angiotensin II/renin regulation by sympathetic tone; High potassium will stimulate and ACTH Increase in aldosterone Disease of the Adrenals 1 Zona Glomerulosa Mineralocorticoids: aldosterone Angiotensin II/renin regulation by sympathetic tone; High potassium will stimulate and ACTH Increase in aldosterone leads to salt

More information

Topic No. & Title: Topic 4 Biosynthesis and secretion of adrenal, ovarian and testicular hormones-factors influencing secretion

Topic No. & Title: Topic 4 Biosynthesis and secretion of adrenal, ovarian and testicular hormones-factors influencing secretion [Academic Script] Biosynthesis and secretion of adrenal, ovarian and testicular hormones-factors influencing secretion Subject: Zoology Course: B.Sc. 2 nd Year Paper No. & Title: Z-203B Vertebrate Endocrinology

More information

THE ADRENAL (SUPRARENAL) GLANDS

THE ADRENAL (SUPRARENAL) GLANDS THE ADRENAL (SUPRARENAL) GLANDS They are two glands, present above the kidneys. One adrenal gland is sufficient for human beings/mammals (example: we also have two kidneys but one is sufficient). The Adrenal

More information

Steroid and Thyroid Hormones. Srbová Martina

Steroid and Thyroid Hormones. Srbová Martina Steroid and Thyroid Hormones Srbová Martina Chemical Classification of Hormones Hormones are chemical messengers that transport signals from one cell to another There are 3 major chemical classes of hormones

More information

Hormones. Introduction to Endocrine Disorders. Hormone actions. Modulation of hormone levels. Modulation of hormone levels

Hormones. Introduction to Endocrine Disorders. Hormone actions. Modulation of hormone levels. Modulation of hormone levels Introduction to Endocrine Disorders Hormones Self-regulating system (homeostasis) Affect: Growth Metabolism Reproduction Fluid and electrolyte balance Hormone actions Endocrine gland Hormone synthesis

More information

Where in the adrenal cortex is cortisol produced? How do glucocorticoids inhibit prostaglandin production?

Where in the adrenal cortex is cortisol produced? How do glucocorticoids inhibit prostaglandin production? CASE 35 A 36-year-old woman presents to her gynecologist with complaints of amenorrhea and hirsutism. She has also noticed an increase in her weight (especially in the trunk region) and easy fatigability.

More information

ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ ΚΑΙ ΑΝΤΑΓΩΝΙΣΤΕΣ ΑΛΔΟΣΤΕΡΟΝΗΣ ΣΠΥΡΟΜΗΤΡΟΣ ΓΕΩΡΓΙΟΣ MD, FESC. E.Α Κ/Δ Γ.Ν.ΚΑΤΕΡΙΝΗΣ

ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ ΚΑΙ ΑΝΤΑΓΩΝΙΣΤΕΣ ΑΛΔΟΣΤΕΡΟΝΗΣ ΣΠΥΡΟΜΗΤΡΟΣ ΓΕΩΡΓΙΟΣ MD, FESC. E.Α Κ/Δ Γ.Ν.ΚΑΤΕΡΙΝΗΣ ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ ΚΑΙ ΑΝΤΑΓΩΝΙΣΤΕΣ ΑΛΔΟΣΤΕΡΟΝΗΣ ΣΠΥΡΟΜΗΤΡΟΣ ΓΕΩΡΓΙΟΣ MD, FESC. E.Α Κ/Δ Γ.Ν.ΚΑΤΕΡΙΝΗΣ Aldosterone is a mineralocorticoid hormone synthesized by the adrenal glands that has several regulatory

More information

Lab Activity 21. Endocrine System Glucometer. Portland Community College BI 232

Lab Activity 21. Endocrine System Glucometer. Portland Community College BI 232 Lab Activity 21 Endocrine System Glucometer Portland Community College BI 232 2 Hormone Functions ACTH (adrenocorticotropic hormone) Regulates the activity of the cortex of the adrenal gland TSH (thyroid

More information

Chemical Classification of Hormones

Chemical Classification of Hormones Steroid Hormones Chemical Classification of Hormones Hormones are chemical messengers that transport signals from one cell to another There are 4 major chemical classes of hormones steroid hormones - i.e.

More information

Adrenal Pharmacology

Adrenal Pharmacology Adrenal Pharmacology Pharmacology Team Naim Kittana, Suhaib Hattab, Ansam Sawalha, Adham Abu Taha, Waleed Sweileh, Ramzi Shawahneh Faculty of Medicine & Health Sciences An-Najah National University 1 Steroidal

More information

The Adrenals Are a key factor in all hormonal issues Because the adrenals can convert one hormone to another they play a role like no other in the bod

The Adrenals Are a key factor in all hormonal issues Because the adrenals can convert one hormone to another they play a role like no other in the bod The Players Part II The Adrenals Are a key factor in all hormonal issues Because the adrenals can convert one hormone to another they play a role like no other in the body Can affect all hormone systems

More information

Endocrine. Endocrine as it relates to the kidney. Sarah Elfering, MD University of Minnesota

Endocrine. Endocrine as it relates to the kidney. Sarah Elfering, MD University of Minnesota Endocrine Sarah Elfering, MD University of Minnesota Endocrine as it relates to the kidney Parathyroid gland Vitamin D Endocrine causes of HTN Adrenal adenoma PTH Bone Kidney Intestine 1, 25 OH Vitamin

More information

Control. Mineralocorticoids Glucocorticoids Weak Androgens. Progesterone, Estrogens. Androgens. Scheme

Control. Mineralocorticoids Glucocorticoids Weak Androgens. Progesterone, Estrogens. Androgens. Scheme Biosynthesis of Steroid Hormones Lipid hormones with intracellular receptors, ell-specific enzyme sortiment, N storage : acutely synthesized when needed Scheme ontrol Mineralocorticoids Glucocorticoids

More information

The endocrine system is made up of a complex group of glands that secrete hormones.

The endocrine system is made up of a complex group of glands that secrete hormones. 1 10. Endocrinology I MEDCHEM 535 Diagnostic Medicinal Chemistry Endocrinology The endocrine system is made up of a complex group of glands that secrete hormones. These hormones control reproduction, metabolism,

More information

CHOLESTEROL IS THE PRECURSOR OF STERIOD HORMONES

CHOLESTEROL IS THE PRECURSOR OF STERIOD HORMONES HORMONES OF ADRENAL CORTEX R. Mohammadi Biochemist (Ph.D.) Faculty member of Medical Faculty CHOLESTEROL IS THE PRECURSOR OF STERIOD HORMONES CONVERSION OF CHOLESTROL TO PREGNENOLONE MINERALOCORTICOCOIDES

More information

16. ADRENAL GLAND FUNCTIONAL ANATOMY OF THE ADRENAL GLAND ADRENAL GLAND

16. ADRENAL GLAND FUNCTIONAL ANATOMY OF THE ADRENAL GLAND ADRENAL GLAND 16. ADRENAL GLAND FUNCTIONAL ANATOMY OF THE ADRENAL GLAND To understand the function of the adrenal gland, it is useful to understand the anatomical and histological differences of each section. The gland

More information

4/23/2015. Objectives DISCLOSURES

4/23/2015. Objectives DISCLOSURES 2015 PENS Conference Savannah, GA Novel Cases of Congenital Hyperreninemic Hypaldosteronism Jan M. Foote DISCLOSURES I have no actual or potential conflicts of interest in relation to this presentation.

More information

Adrenal Steroids Mineralocorticoids & Glucocorticoids. Munir Gharaibeh, MD, PhD, MHPE Faculty of Medicine The Jordan University April 2014

Adrenal Steroids Mineralocorticoids & Glucocorticoids. Munir Gharaibeh, MD, PhD, MHPE Faculty of Medicine The Jordan University April 2014 Adrenal Steroids Mineralocorticoids & Glucocorticoids Munir Gharaibeh, MD, PhD, MHPE Faculty of Medicine The Jordan University April 2014 Medulla (E, NE) Adrenal Gland Cortex Mineralocorticoids (Aldosterone)

More information

Blood Pressure Regulation 2. Faisal I. Mohammed, MD,PhD

Blood Pressure Regulation 2. Faisal I. Mohammed, MD,PhD Blood Pressure Regulation 2 Faisal I. Mohammed, MD,PhD 1 Objectives Outline the intermediate term and long term regulators of ABP. Describe the role of Epinephrine, Antidiuretic hormone (ADH), Renin-Angiotensin-Aldosterone

More information

Blood Pressure Regulation 2. Faisal I. Mohammed, MD,PhD

Blood Pressure Regulation 2. Faisal I. Mohammed, MD,PhD Blood Pressure Regulation 2 Faisal I. Mohammed, MD,PhD 1 Objectives Outline the intermediate term and long term regulators of ABP. Describe the role of Epinephrine, Antidiuretic hormone (ADH), Renin-Angiotensin-Aldosterone

More information

Endocrinology Introductory Lectures

Endocrinology Introductory Lectures Endocrinology Introductory Lectures What do You Want to Become? Veysman, B. BMJ 2005;331:1529 Definitions Endocrine Gland: secretes a hormone into the circulation Hormone: Chemical substance produced by

More information

pharmacology sheet #9 Adrenal Steroids Mineral corticoids & Glucocorticoids

pharmacology sheet #9 Adrenal Steroids Mineral corticoids & Glucocorticoids Adrenal Steroids Mineral corticoids & Glucocorticoids Extra notes : Slide 2: - All Steroids are synthesized in the adrenal gland and secreted from it, It consists of an outer cortex and an inner medulla.

More information

BIOSYNTHESIS OF STEROID HORMONES

BIOSYNTHESIS OF STEROID HORMONES BIOSYNTHESIS OF STEROID HORMONES Sri Widia A Jusman Department of Biochemistry & Molecular Biology FMUI sw/steroidrepro/inter/08 1 STEROID HORMONES Progestins (21 C) Glucocorticoids (21 C) Mineralocorticoids

More information

John Sutton, DO, FACOI, FACE, CCD. Carson Tahoe Endocrinology Carson City, NV KCOM Class of 1989

John Sutton, DO, FACOI, FACE, CCD. Carson Tahoe Endocrinology Carson City, NV KCOM Class of 1989 John Sutton, DO, FACOI, FACE, CCD Carson Tahoe Endocrinology Carson City, NV KCOM Class of 1989 Gonadal Physiology and Disease 3 No Disclosures Gonadal Axis Hypothalamic-pituitary-gonadal Feedback mechanisms

More information

Regulation of Arterial Blood Pressure 2 George D. Ford, Ph.D.

Regulation of Arterial Blood Pressure 2 George D. Ford, Ph.D. Regulation of Arterial Blood Pressure 2 George D. Ford, Ph.D. OBJECTIVES: 1. Describe the Central Nervous System Ischemic Response. 2. Describe chemical sensitivities of arterial and cardiopulmonary chemoreceptors,

More information

Mineralocorticoids. Introduction

Mineralocorticoids. Introduction Mineralocorticoids Introduction concepts to remember: a) water, glucose, mineral metabolism; b) adrenal in stress and blood pressure 15 Renin - angiotensin (RAS) and kallikrein kinin (KKS) systems: synthesis,

More information

ULTIMATE BEAUTY OF BIOCHEMISTRY. Dr. Veena Bhaskar S Gowda Dept of Biochemistry 30 th Nov 2017

ULTIMATE BEAUTY OF BIOCHEMISTRY. Dr. Veena Bhaskar S Gowda Dept of Biochemistry 30 th Nov 2017 ULTIMATE BEAUTY OF BIOCHEMISTRY Dr. Veena Bhaskar S Gowda Dept of Biochemistry 30 th Nov 2017 SUSPECTED CASE OF CUSHING S SYNDROME Clinical features Moon face Obesity Hypertension Hunch back Abdominal

More information

1. Urinary System, General

1. Urinary System, General S T U D Y G U I D E 16 1. Urinary System, General a. Label the figure by placing the numbers of the structures in the spaces by the correct labels. 7 Aorta 6 Kidney 8 Ureter 2 Inferior vena cava 4 Renal

More information

Ch 8: Endocrine Physiology

Ch 8: Endocrine Physiology Ch 8: Endocrine Physiology Objectives 1. Review endocrine glands of body. 2. Understand how hypothalamus controls endocrine system & sympathetic epinephrine response. 3. Learn anterior pituitary hormones

More information

Human Anatomy and Physiology - Problem Drill 16: The Endocrine System

Human Anatomy and Physiology - Problem Drill 16: The Endocrine System Human Anatomy and Physiology - Problem Drill 16: The Endocrine System Question No. 1 of 10 The endocrine system is made up of a number of organs and glands. Which one of the following is not an organ or

More information

Endocrine System. Modified by M. Myers

Endocrine System. Modified by M. Myers Endocrine System Modified by M. Myers 1 The Endocrine System 2 Endocrine Glands The endocrine system is made of glands & tissues that secrete hormones. Hormones are chemicals messengers influencing a.

More information

Medical management of Intersex disorders. Dr. Abdulmoein Al-Agha, Ass. Professor & Consultant Pediatric Endocrinologist KAAUH, Jeddah

Medical management of Intersex disorders. Dr. Abdulmoein Al-Agha, Ass. Professor & Consultant Pediatric Endocrinologist KAAUH, Jeddah Medical management of Intersex disorders Dr. Abdulmoein Al-Agha, Ass. Professor & Consultant Pediatric Endocrinologist KAAUH, Jeddah Is it a boy or a girl? The birth of an intersex infant is often viewed

More information

Corticosteroids. Hawler Medical University College of Medicine Department of Pharmacology and Biophysics Dr.Susan Abdulkadir Farhadi MSc Pharmacology

Corticosteroids. Hawler Medical University College of Medicine Department of Pharmacology and Biophysics Dr.Susan Abdulkadir Farhadi MSc Pharmacology Corticosteroids Hawler Medical University College of Medicine Department of Pharmacology and Biophysics Dr.Susan Abdulkadir Farhadi MSc Pharmacology Objectives By the end of this lecture you should be

More information

ADRENAL GLANDS HORMONES

ADRENAL GLANDS HORMONES ADRNAL GLANDS HORMONS Glands Cortex 80% mesoderm Mineralococorticoids Glucocorticoids (phenylethanolamine N- methyl transferase) A Sex Hormones Catecholamines Medulla 20% PNMT, N neuroectoderm N PNMT V

More information

ظظظ/ -Amera Al- zoubi -Osama Khader. - Mousa Alabbadi. 0 P a g e

ظظظ/ -Amera Al- zoubi -Osama Khader. - Mousa Alabbadi. 0 P a g e ظظظ/ -4 -Amera Al- zoubi -Osama Khader - Mousa Alabbadi 0 P a g e In the previous lecture we started talking about the acute complications of diabetes mellitus which can be fatal. They are hyperosmolar

More information

I PU Biology Chemical Coordination

I PU Biology Chemical Coordination I PU Biology Chemical Coordination Questions carrying 1 Mark each. 1. Define hormone. 2. Mention the name of the neurosecretorycells,which secrete the hormone in the hypothalamus. 3. Which of the endocrine

More information

The Adrenal Glands. I. Normal adrenal gland A. Gross & microscopic B. Hormone synthesis, regulation & measurement. II.

The Adrenal Glands. I. Normal adrenal gland A. Gross & microscopic B. Hormone synthesis, regulation & measurement. II. The Adrenal Glands Thomas Jacobs, M.D. Diane Hamele-Bena, M.D. I. Normal adrenal gland A. Gross & microscopic B. Hormone synthesis, regulation & measurement II. Hypoadrenalism III. Hyperadrenalism; Adrenal

More information

Diseases of the Adrenal gland

Diseases of the Adrenal gland Diseases of the Adrenal gland Adrenal insufficiency Cushing disease vs syndrome Pheochromocytoma Hyperaldostronism What are the layers of the adrenal gland?? And what does each layer produce?? What are

More information

SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY & MOLECULAR BIOLOGY

SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY & MOLECULAR BIOLOGY 1 SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY & MOLECULAR BIOLOGY PBL SEMINAR: SEX HORMONES PART 1 An Overview What are steroid hormones? Steroid

More information

Biochemistry Exam 3 Dec 9, All of the following are true of skeletal muscle contraction EXCEPT

Biochemistry Exam 3 Dec 9, All of the following are true of skeletal muscle contraction EXCEPT Biochemistry Exam 3 Dec 9, 1996 1 1. All of the following are true of skeletal muscle contraction EXCEPT A. ATP binds to myosin and causes myosin to detach from actin B. Myosin catalyzes the reversible

More information

Biology 2100 Human Physiology C. Iltis SLCC March 8, Midterm Examination #2

Biology 2100 Human Physiology C. Iltis SLCC March 8, Midterm Examination #2 Biology 2100 Human Physiology Name: KEY C. Iltis SLCC March 8, 2000 Midterm Examination #2 Multiple Choice Questions (2 POINTS EACH) 1. When glucose levels are above 100 mg/dl, which of the following is

More information

Endocrine System. Chapter 18. Introduction. How Hormones Work. How Hormones Work. The Hypothalamus & Endocrine Regulation

Endocrine System. Chapter 18. Introduction. How Hormones Work. How Hormones Work. The Hypothalamus & Endocrine Regulation Introduction Endocrine System Chapter 18 The endocrine system consists of cells, tissues, & organs that secrete into the blood Hormone an organic substance secreted by a cell that has an effect on the

More information

Table of Contents Section I Pituitary and Hypothalamus 1. Development of the Pituitary Gland 2. Divisions of the Pituitary Gland and Relationship to

Table of Contents Section I Pituitary and Hypothalamus 1. Development of the Pituitary Gland 2. Divisions of the Pituitary Gland and Relationship to Table of Contents Section I Pituitary and Hypothalamus 1. Development of the Pituitary Gland 2. Divisions of the Pituitary Gland and Relationship to the Hypothalamus 3. Blood Supply of the Pituitary Gland

More information

Year 2004 Paper two: Questions supplied by Megan 1

Year 2004 Paper two: Questions supplied by Megan 1 Year 2004 Paper two: Questions supplied by Megan 1 QUESTION 96 A 32yo woman if found to have high blood pressure (180/105mmHg) at an insurance medical examination. She is asymptomatic. Clinical examination

More information

Section 3, Lecture 2

Section 3, Lecture 2 59-291 Section 3, Lecture 2 Diuretics: -increase in Na + excretion (naturesis) Thiazide and Related diuretics -decreased PVR due to decreases muscle contraction -an economical and effective treatment -protect

More information

Autonomic Nervous System. Part of the nervous system that controls most of the visceral functions of the body ( Automatically?

Autonomic Nervous System. Part of the nervous system that controls most of the visceral functions of the body ( Automatically? Autonomic Response? Autonomic Nervous System Part of the nervous system that controls most of the visceral functions of the body ------ ( Automatically?) Classification Of CNS Autonomic Nervous System

More information

Adrenocorticosteroids

Adrenocorticosteroids Adrenocorticosteroids Divided into those having: 1. Important effects on intermediary metabolism and immune function = glucocorticoids (cortisol). 2. Salt-retaining activity = mineralocorticoids (aldosterone).

More information

PTA/OTA 106 Unit 2 Lecture 4 Introduction to the Endocrine System

PTA/OTA 106 Unit 2 Lecture 4 Introduction to the Endocrine System PTA/OTA 106 Unit 2 Lecture 4 Introduction to the Endocrine System 1 Anterior Pituitary or Adenohypophysis Corticotrophs Adrenocorticotropic hormone (ACTH) Hypothalamic Control Corticotropic releasing hormone

More information

Endocrine System. Regulating Blood Sugar. Thursday, December 14, 17

Endocrine System. Regulating Blood Sugar. Thursday, December 14, 17 Endocrine System Regulating Blood Sugar Stress results in nervous and hormonal responses. The adrenal glands are located above each kidney. Involved in stress response. Stress Upsets Homeostasis Stress

More information

A case of 17 alpha-hydroxylase deficiency

A case of 17 alpha-hydroxylase deficiency CASE REPORT pissn 2233-8233 eissn 2233-8241 Clin Exp Reprod Med 2015;42(2):72-76 A case of 17 alpha-hydroxylase deficiency Sung Mee Kim 1, Jeong Ho Rhee 2 1 Saint Mary s Women s Hospital, Daegu; 2 Department

More information

Class XI Chapter 19 Excretory Products and their Elimination Biology

Class XI Chapter 19 Excretory Products and their Elimination Biology Class XI Chapter 19 Excretory Products and their Elimination Biology Question 1: Define Glomerular Filtration Rate (GFR) Glomerular filtration rate is the amount of glomerular filtrate formed in all the

More information

Hd Hydroxylase. Cholesterol. 17-OH Pregnenolne DHEA Andrstendiol. Pregnenolone. 17-OH Progestrone. Androstendione. Progestrone.

Hd Hydroxylase. Cholesterol. 17-OH Pregnenolne DHEA Andrstendiol. Pregnenolone. 17-OH Progestrone. Androstendione. Progestrone. PATHOPHISIOLOGY OF SEX HORMONES R. Mohammadi Biochemist (Ph.D.) Faculty member of Medical Faculty CHOLESTEROL IS THE PRECURSOR OF STERIOD HORMONES Cholesterol Pregnenolone 17-OH 17βHSD Pregnenolne DHEA

More information

When testes make no testosterone: Identifying a rare cause of 46, XY female phenotype in adulthood

When testes make no testosterone: Identifying a rare cause of 46, XY female phenotype in adulthood When testes make no testosterone: Identifying a rare cause of 46, XY female phenotype in adulthood Gardner DG, Shoback D. Greenspan's Basic & Clinical Endocrinology, 10e; 2017 Sira Korpaisarn, MD Endocrinology

More information

TKheory Section: [Total 16 Marks]

TKheory Section: [Total 16 Marks] Bloomfield Hall School Test (Unit 0-) Name :... Pa: Biolog y Date :... Class: FIV Time Allowed: 0Minutes Maximum Marks: TKheory Section: [Total 6 Marks] (a) Define the term excretion. [] (b) Fig.. shows

More information

Catecholamines 13. Today s lecture. Page 1. Adrenal medulla and its story lines

Catecholamines 13. Today s lecture. Page 1. Adrenal medulla and its story lines Catecholamines 13 Introduction to the adrenal and to the stress response: autonomic nervous system, endocrine / neural components catecholamines: synthesis, secretion, receptors, mechanism of action, general

More information

Therefore MAP=CO x TPR = HR x SV x TPR

Therefore MAP=CO x TPR = HR x SV x TPR Regulation of MAP Flow = pressure gradient resistance CO = MAP TPR Therefore MAP=CO x TPR = HR x SV x TPR TPR is the total peripheral resistance: this is the combined resistance of all blood vessels (remember

More information

International Journal of Health Sciences and Research ISSN:

International Journal of Health Sciences and Research   ISSN: International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Congenital Adrenal Hyperplasia in Saudi Arabia: The Biochemical Characteristics Nasir A. M.

More information

DEFINITION: Masculinization of external genitalia in patients with normal 46XX karyotype.

DEFINITION: Masculinization of external genitalia in patients with normal 46XX karyotype. INTERSEX DISORDERS DEFINITION: Masculinization of external genitalia in patients with normal 46XX karyotype. - Degree of masculinization variable: - mild clitoromegaly - complete fusion of labia folds

More information

THE HIGHS AND LOWS OF ADRENAL GLAND PATHOLOGY

THE HIGHS AND LOWS OF ADRENAL GLAND PATHOLOGY THE HIGHS AND LOWS OF ADRENAL GLAND PATHOLOGY Symptoms of Adrenal Gland Disorders 2 Depends on whether it is making too much or too little hormone And on what you Google! Symptoms include obesity, skin

More information

The adrenal gland consists of the cortex & the medulla. Medulla secretes epinephrine, whereas cortex synthesizes & secretes two major classes of

The adrenal gland consists of the cortex & the medulla. Medulla secretes epinephrine, whereas cortex synthesizes & secretes two major classes of Adrenocorticosteroids Dr. Entisar Al-Mukhtar The adrenal gland consists of the cortex & the medulla. Medulla secretes epinephrine, whereas cortex synthesizes & secretes two major classes of steroid hormones:

More information

Adrenal Hormone Mineralocorticoids Aldosterone

Adrenal Hormone Mineralocorticoids Aldosterone Adrenal gland Adrenal Hormone Mineralocorticoids Aldosterone Cortex 80 % Glucocorticoids Cortisol Sex hormones Androgen Medulla 20% Catecholamines E, NE 1 2 Adrenal cortex hormones Glucocorticoid Mineralocorticoids

More information

Decreased Insulin Receptor Kinase Activity in Gestational Diabetes Mellitus

Decreased Insulin Receptor Kinase Activity in Gestational Diabetes Mellitus ENDOCRINOLOGY Decreased Insulin Receptor Kinase Activity in Gestational Diabetes Mellitus during pregnancy decrease in insulin sensitivity helps provide adequate glucose for the developing fetus 14% of

More information

Renal System and Excretion

Renal System and Excretion Renal System and Excretion Biology 105 Lecture 19 Chapter 16 Outline Renal System I. Functions II. Organs of the renal system III. Kidneys 1. Structure 2. Function IV. Nephron 1. Structure 2. Function

More information

Indications for Surgical Removal of Adrenal Glands

Indications for Surgical Removal of Adrenal Glands The adrenal glands are orange-colored endocrine glands which are located on the top of both kidneys. The adrenal glands are triangular shaped and measure about one-half inch in height and 3 inches in length.

More information

Chapter-13. Hormones and Signal Transduction. Page /8/2017 Dr. Amjid Iqbal PhD (University of Cambridge) 1

Chapter-13. Hormones and Signal Transduction. Page /8/2017 Dr. Amjid Iqbal PhD (University of Cambridge) 1 Chapter-13 Hormones and Signal Transduction Page 396-401 Dr. Amjid Iqbal PhD (University of 1 Living things coordinate their activities through biochemical signaling system Intercellular signals are mediated

More information

Endocrine System. Endocrine vs. Exocrine. Bio 250 Human Anatomy & Physiology

Endocrine System. Endocrine vs. Exocrine. Bio 250 Human Anatomy & Physiology Endocrine System Bio 250 Human Anatomy & Physiology Endocrine vs. Exocrine Endocrine glands secrete their products called hormones into body fluids (the internal environment) Exocrine glands secrete their

More information

Sunday, July 17, 2011 URINARY SYSTEM

Sunday, July 17, 2011 URINARY SYSTEM URINARY SYSTEM URINARY SYSTEM Let s take a look at the anatomy first! KIDNEYS: are complex reprocessing centers where blood is filtered through and waste products are removed. Wastes and extra water become

More information

Endocrine Hypertension

Endocrine Hypertension Endocrine Hypertension 1 No Disclosures Endocrine Hypertension Objectives: 1. Understand Endocrine disorders causing hypertension 2. Understand clinical presentation of Pheochromocytoma and Hyperaldosteronism

More information

Approach to Adrenal Incidentaloma. Alice Y.Y. Cheng, MD, FRCP

Approach to Adrenal Incidentaloma. Alice Y.Y. Cheng, MD, FRCP Approach to Adrenal Incidentaloma Alice Y.Y. Cheng, MD, FRCP Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form

More information

The Work-up and Treatment of Adrenal Nodules

The Work-up and Treatment of Adrenal Nodules The Work-up and Treatment of Adrenal Nodules Lawrence Andrew Drew Shirley, MD, MS, FACS Assistant Professor of Surgical-Clinical Department of Surgery Division of Surgical Oncology The Ohio State University

More information

Case Based Urology Learning Program

Case Based Urology Learning Program Case Based Urology Learning Program Resident s Corner: UROLOGY Case Number 4 CBULP 2010 004 Case Based Urology Learning Program Editor: Associate Editors: Manager: Case Contributors: Steven C. Campbell,

More information

5. Maintaining the internal environment. Homeostasis

5. Maintaining the internal environment. Homeostasis 5. Maintaining the internal environment Homeostasis Blood and tissue fluid derived from blood, flow around or close to all cells in the body. Blood and tissue fluid form the internal environment of the

More information

Structure and organization of blood vessels

Structure and organization of blood vessels The cardiovascular system Structure of the heart The cardiac cycle Structure and organization of blood vessels What is the cardiovascular system? The heart is a double pump heart arteries arterioles veins

More information

The Endocrine System 2

The Endocrine System 2 The Endocrine System 2 Continuing on from the previous instalment, we will now look at the adrenal glands, the pancreas and the gonads as parts of the endocrine system. Adrenal Glands The adrenal glands

More information

Wit JM, Ranke MB, Kelnar CJH (eds): ESPE classification of paediatric endocrine diagnosis. 8. Adrenal disorders. Horm Res 2007;68(suppl 2):55 57

Wit JM, Ranke MB, Kelnar CJH (eds): ESPE classification of paediatric endocrine diagnosis. 8. Adrenal disorders. Horm Res 2007;68(suppl 2):55 57 Wit JM, Ranke MB, Kelnar CJH (eds): ESPE classification of paediatric endocrine diagnosis. 8. Adrenal disorders. Horm Res 2007;68(suppl 2):55 57 ESPE Code Diagnosis OMIM ICD10 8 ADRENAL DISORDERS 8A PRIMARY

More information

BODY FLUID. Outline. Functions of body fluid Water distribution in the body Maintenance of body fluid. Regulation of fluid homeostasis

BODY FLUID. Outline. Functions of body fluid Water distribution in the body Maintenance of body fluid. Regulation of fluid homeostasis BODY FLUID Nutritional Biochemistry Yue-Hwa Chen Dec 13, 2007 Chen 1 Outline Functions of body fluid Water distribution in the body Maintenance of body fluid Intake vs output Regulation of body fluid Fluid

More information

Pathophysiology of Adrenal Disorders

Pathophysiology of Adrenal Disorders Pathophysiology of Adrenal Disorders PHCL 415 Hadeel Alkofide April 2010 Some slides adapted from Rania Aljizani MSc 1 Learning Objectives Describe the roles of the various zones of the adrenal cortex

More information

1. Changed level of a certain hormone Stimulation of the oxygen consumption 3. Decoupling of oxidative phosphorylation 2.

1. Changed level of a certain hormone Stimulation of the oxygen consumption 3. Decoupling of oxidative phosphorylation 2. 1. How can endocrine disorders be classified? 1. Hereditary, acquired 2. Active, passive 3. Uncompensated, overcompensated 4. Primary, secondary 5.1, 4 6.1, 2, 3, 4. ENDOCRINE SYSTEM 2. Which is the MAIN

More information

Endocrine System. Part 2

Endocrine System. Part 2 Endocrine System Part 2 Thyroid Gland Saddle bag shaped gland Largest endocrine gland in the body 3 hormones Throxin Triiodothyronine Calcitonin Thyroid hormone Pineal gland Hypothalamus Pituitary gland

More information

Adrenal Mass. Cynthia Kwong SUNY Downstate Medical Center Grand Rounds October 13, 2016

Adrenal Mass. Cynthia Kwong SUNY Downstate Medical Center Grand Rounds October 13, 2016 Adrenal Mass Cynthia Kwong SUNY Downstate Medical Center Grand Rounds October 13, 2016 Case Presentation 65F found to have a 4cm left adrenal mass in 2012 now presents with 6.7cm left adrenal mass PMHx:

More information

2402 : Anatomy/Physiology

2402 : Anatomy/Physiology Dr. Chris Doumen Lecture 4 2402 : Anatomy/Physiology Major Endocrine Organs Calci u m H o me os t asis TextBook Readings Pages 624 through 632. Make use of the figures in your textbook ; a picture is worth

More information

The Endocrine System/Hormones

The Endocrine System/Hormones The Endocrine System/Hormones Controls many body functions exerts control by releasing special chemical substances into the blood called hormones Hormones affect other endocrine glands or body systems

More information

DECLARATION OF CONFLICT OF INTEREST

DECLARATION OF CONFLICT OF INTEREST DECLARATION OF CONFLICT OF INTEREST Novel approaches in hypertension Aldosterone-synthase inhibitors. Faiez Zannad Nancy, France Disclosures Dr Zannad reports receiving Speaker/consultant honoraria from

More information

REPRODUCTIVE ENDOCRINOLOGY OF THE MALE

REPRODUCTIVE ENDOCRINOLOGY OF THE MALE Reproductive Biotechnologies Andrology I REPRODUCTIVE ENDOCRINOLOGY OF THE MALE Prof. Alberto Contri REPRODUCTIVE ENDOCRINOLOGY OF THE MALE SPERMATOGENESIS AND REPRODUCTIVE BEHAVIOR RELATED TO THE ACTIVITY

More information

Questions? Homework due in lab 6. PreLab #6 HW 15 & 16 (follow directions, 6 points!)

Questions? Homework due in lab 6. PreLab #6 HW 15 & 16 (follow directions, 6 points!) Questions? Homework due in lab 6 PreLab #6 HW 15 & 16 (follow directions, 6 points!) Part 3 Variations in Urine Formation Composition varies Fluid volume Solute concentration Variations in Urine Formation

More information

Endocrinology and VHL: The adrenal and the pancreas

Endocrinology and VHL: The adrenal and the pancreas Overview Endocrinology and VHL: The adrenal and the pancreas LAUREN FISHBEIN MD, PHD UNIVERSITY OF COLORADO SCHOOL OF MEDICINE DIVISION OF ENDOCRINOLOGY, METABOLISM AND DIABETES DIVISION OF BIOMEDICAL

More information

NOTES 11.5: ENDOCRINE SYSTEM. Pages

NOTES 11.5: ENDOCRINE SYSTEM. Pages NOTES 11.5: ENDOCRINE SYSTEM Pages 1031-1042 ENDOCRINE SYSTEM Communication system that controls metabolism, growth, and development with hormones Maintains homeostasis Hormones: chemical messengers released

More information

Adrenal Glands. Huiping Wang ( 王会平 ), PhD. Rm C541, Block C, Research Building, School of Medicine Tel:

Adrenal Glands. Huiping Wang ( 王会平 ), PhD. Rm C541, Block C, Research Building, School of Medicine Tel: Adrenal Glands Huiping Wang ( 王会平 ), PhD Department of Physiology Rm C541, Block C, Research Building, School of Medicine Tel: 88208292 Outline The Adrenal Glands The adrenal cortex The Adrenal Medulla

More information

Calcium & Phosphorus. Mineral balance and bone physiology

Calcium & Phosphorus. Mineral balance and bone physiology Calcium & Phosphorus Mineral balance and bone physiology Calcium 5th most abundant element on earth Free form is synthesized from CaCl 2 Calcium Adult average: 1100 gr (99% of which is in the bones) Plasma

More information

Hormones and the Endocrine System Chapter 45. Intercellular communication. Paracrine and Autocrine Signaling. Signaling by local regulators 11/26/2017

Hormones and the Endocrine System Chapter 45. Intercellular communication. Paracrine and Autocrine Signaling. Signaling by local regulators 11/26/2017 Hormones and the Endocrine System Chapter 45 Intercellular communication Endocrine signaling Local regulators Paracrine and autocrine signaling Neuron signaling Synaptic and neuroendocrine signaling Paracrine

More information

Adrenal Gland. Stress.

Adrenal Gland. Stress. Adrenal Gland. Stress. Adrenal gland Adrenal cortex steroid hormones Glucocorticoids (metabolism of carbohydrates and proteins) Mineralocorticoids (maintenance of Na + balance, ECF volume) Sex hormones

More information

Receptors Functions and Signal Transduction L1- L2

Receptors Functions and Signal Transduction L1- L2 Receptors Functions and Signal Transduction L1- L2 Faisal I. Mohammed, MD, PhD University of Jordan 1 Introduction to Physiology (0501110) Spring 2013 Subject Receptors: types and adaptation - Membrane

More information

Chapter 6. The Adrenal Gland

Chapter 6. The Adrenal Gland Chapter 6 The Adrenal Gland The adrenal produces three major classes of hormones, each of which aid in dealing with the multitude of small and large stresses faced by people almost daily. At least two

More information