SlideShare ist ein Scribd-Unternehmen logo
1 von 23
Downloaden Sie, um offline zu lesen
ADRENAL GLAND
  DISORDERS
INTRODUCTION
• Each person has 2 adrenal glands
• 2 separate glands with independent function
• Hypofunction and hyperfunction of adrenal cortex
REVIEW OF ANATOMY AND
               PHYSIOLOGY
Adrenal gland



Cortex      medulla
•          Adrenal cortex

Glucocorticoids mineralocorticoids sex

Hydro cortisone corticosterone
• Medulla
a. Epinephrine
b. nor epineprine
ADISSONS DISEASE
DEFINITION:
Inadequate secretion of ATCH
  from pitutary gland results
  adrenal in sufficiency . Primary
  adrenal insufficiency results
  from idiopathic atropy or
  destruction of adrenal glands
  by autoimmune process.
ETIOLOGY AND RISK FACTORS
• Tuberculosis (TB) :TB is an infection which
  usually affects the lungs. In some cases the
  infection can spread to, and gradually
  destroy, the adrenals
• Other infections can sometimes affect
  both adrenals.
• Cancers of other parts of the body can
  spread and destroy the adrenals.
• Rare hereditary conditions.
• adrenalectomy
• Auto immune diseases: auto-immune
  diseases the immune system makes
  antibodies against part or parts of the
  body. In auto-immune Addison's disease,
  you make antibodies which attach to cells
  in the adrenal cortex
CLINICAL MANIFESTATION
• General weakness and becoming easily tired.
• Darkened areas of skin ('pigmentation').
• Blood pressure is low and falls further when
  you stand which can make you dizzy.
• Being off your food and weight loss.
• Feeling sick and vomiting from time to time.
• Abdominal pains which may come and go.
• Diarrhoea or constipation which may come and
  go.
• Cramps and pains in muscles.
• Craving for salt, or salty foods and drinks.
• Menstrual periods in women may become
  irregular, or stop.
DIAGNOSTIC TESTS
•   Serum electrolyte levels
•   Blood glucose levels
•   CBC
•   X ray studies
•   Computed tomography
•   MRI
TREATMENT
• Cortisol replacement
• You need steroid medication to replace the cortisol
  which you no longer make. This is usually with a
  medicine called hydrocortisone which is very similar to
  cortisol. The amount is usually about 15-25 mg each
  day. Some people need more than this, and others less.
  The daily amount is broken up into two or three doses
  each day with a higher dose taken in the morning than
  in the evening. For example, you may be advised to
  take 15 mg in the morning and 10 mg early evening.
• Replacing aldosterone
Fludrocortisone is a substitute medicine for
  aldosterone. This helps to regulate blood
  pressure and blood salt level. You may also be
  advised to take extra salt each day.
• Addisonian crisis
• This is a medical emergency. You will be given
  hydrocortisone injections, a 'drip' of fluid to bring
  up your blood pressure, and may need intensive
  care until the crisis is over. then need to continue
  taking hydrocortisone medication
CUSHING SYNDROME
• DEFINITION:. Cushing's syndrome develops
  when the level of a glucocorticoid in your
  body is too high over a long period of time.
  Too much glucocorticoid can occur from an
  exogenous or endogenous source
ETIOLOGY
• Adrenal hyperplasia - which means there is
  increased number and growth of the cells in
  the adrenal glands. These cells then make too
  much cortisol. There are various different
  types of adrenal hyperplasia.
• A benign (noncancerous) tumour of an
  adrenal gland.
• A malignant (cancerous) tumour of an adrenal
  gland
SIGNS AND SYMPTOMS
• Obesity -
• Facial puffiness, and the face often looks redder
  than usual.
• Diabetes.
• Facial hair in women.
• High blood pressure.
• Muscle weakness.
• Thin skin which bruises easily.
• Purple/pink stretch marks
• Tiredness.
• Aches and pains - particularly backache.
• Mood swings - such as being more irritable,
  depressed, or anxious than usual.
• Lack of sex drive (libido).
• Periods may become irregular, or stop, in
  women.
• Osteoporosis . You may fracture a bone more
  easily than usual.
• Oedema around the ankles.
DIAGNOSTIC TESTS
•   Serum cortisol levels
•   Salivary cortisol levels
•   ACTH Level
•   ACTH Test
•   Pituitary MRI
TREATMENT
• Radiotherapy to the pituitary gland can destroy the pituitary
  adenoma. This has a good chance of success, but may take months
  or years to take effect. Medication (see below) may be needed until
  the radiation treatment takes effect. Also, the radiotherapy may
  damage the normal pituitary cells, and may cause low levels of
  other hormones made by the pituitary gland. However,
  replacement hormone therapy can usually be taken if this occurs.
• Surgery to remove both adrenal glands is an option. This stops your
  body making any cortisol (and other hormones) from your adrenal
  glands. You will need lifelong replacement therapy of certain
  hormones. However, the adenoma will remain in the pituitary and
  continue to produce high levels of ACTH which can cause problems
  in some cases.
• Medication to block the production or effects of cortisol may work.
  There are several medicines which can be tried with various levels
  of success.
PHEOCHROMACYTOMA
DEFINITION:
Pheochromacytoma is a catecholamine
  secreting tumor of the cromaffin cells of the
  sympathetic nervous system it is usually found
  in the adrenal medulla.
SYMPTOMS
•   Abdominal pain
•   Chest pain
•   Irritability
•   Nervousness
•   Pallor
•   Palpitations
•   Rapid heart rate
•   Severe headache
•   Sweating
•   Weight loss
DIAGNOSTIC TESTS
•   Abdominal CT scan
•   Adrenal biopsy
•   Catecholamines blood test
•   Glucose test
•   Metanephrine blood test
•   MIBG scintiscan
•   MRI of abdomen
•   Urine catecholamines
TREATMENT
• Treatment involves removing the tumor with surgery. It
  is important to stabilize blood pressure and pulse with
  medication before surgery. close monitoring of vital
  signs.
• After surgery, it is necessary to continually monitor all
  vital signs in an intensive care unit. When the tumor
  cannot be surgically removed, medication is needed to
  manage it. This usually requires a combination of
  medications to control the effects of the excessive
  hormones. Radiation therapy and chemotherapy have
  not been effective in curing this kind of tumor.
NURSING MANAGEMENT
• Risk for injury related to weakness
• Risk for infection related to altered protein
  metabolism
• Self care deficit related to fatigue and muscle
  wasting
• Altered body image related to tunical obesity
Corticotropin-Releasing Factor Test in Normal Subjects and
         Patients with Hypothalamic-Pituitary-Adrenal Disorders*

•   Corticotropin-releasing factor (CRF) tests were performed in normal subjects and
    patients with hypothalamicpituitary-adrenal disorders. In normal subjects, after iv
    administation of 500 μg synthetic ovine CRF, plasma ACTH rose significantly to
    approximately 3.6 times the basal level at 30–60 min and cortisol reached a peak
    of 2.3 times the basal level at 60–90 min, whereas aldosterone peaked at 1.6 times
    the basal level at 60 min. Injection of 100 μg CRF in normal subjects also caused a
    significant increase in plasma ACTH and cortisol levels but only a slight increase in
    aldosterone. However, the total hormone released and their peak levels were
    lower than those elicited by the 500-μg dosage. In patients with Cushing’s disease,
    although the basal and peak levels of plasma ACTH and cortisol induced by
    administration of CRF were variable, the ratios of increase for the two hormones
    elicited by CRF were lower than those in normal subjects, especially for cortisol. In
    patients with Cushing’s syndrome due to an adrenal adenoma, basal levels of
    ACTH were markedly suppressed and plasma ACTH and cortisol did not rise after
    CRF. In patients with isolated ACTH deficiency or Sheehan’s syndrome the basal
    level of plasma ACTH was less than 5 pg/ml and no change in plasma ACTH
    occurred after injection of CRF. In patients with Nelson’s syndrome or Addison’s
    disease the basal levels of ACTH were extremely elevated but infusion of CRF
    increased plasma ACTH to even higher levels.
presented by,
   samantha
  14/4/2012

Weitere ähnliche Inhalte

Was ist angesagt?

Was ist angesagt? (20)

Addison’s disease
Addison’s diseaseAddison’s disease
Addison’s disease
 
Primary hyperaldosteronism
Primary hyperaldosteronismPrimary hyperaldosteronism
Primary hyperaldosteronism
 
Approach to Cushing Syndrome
Approach to Cushing Syndrome Approach to Cushing Syndrome
Approach to Cushing Syndrome
 
Endocrine week 4 pt
Endocrine week 4 ptEndocrine week 4 pt
Endocrine week 4 pt
 
Cushing's syndrome
Cushing's syndromeCushing's syndrome
Cushing's syndrome
 
Hypopituitarism
HypopituitarismHypopituitarism
Hypopituitarism
 
Addison's disease
Addison's diseaseAddison's disease
Addison's disease
 
Pheochromocytoma
PheochromocytomaPheochromocytoma
Pheochromocytoma
 
Parathyroid disorders
Parathyroid disorders Parathyroid disorders
Parathyroid disorders
 
Cushing's syndrome
Cushing's syndromeCushing's syndrome
Cushing's syndrome
 
Adrenal gland disorders kinara
Adrenal gland disorders kinaraAdrenal gland disorders kinara
Adrenal gland disorders kinara
 
Disease of adrenal gland
Disease of adrenal glandDisease of adrenal gland
Disease of adrenal gland
 
Pheochromocytoma
PheochromocytomaPheochromocytoma
Pheochromocytoma
 
Addison disease by dr shahjada selim
Addison disease by dr shahjada selimAddison disease by dr shahjada selim
Addison disease by dr shahjada selim
 
Adrenal gland diseases and tumors
Adrenal gland diseases and tumorsAdrenal gland diseases and tumors
Adrenal gland diseases and tumors
 
Disorders of pituitarygland
Disorders of pituitaryglandDisorders of pituitarygland
Disorders of pituitarygland
 
Hyperaldosteronism
HyperaldosteronismHyperaldosteronism
Hyperaldosteronism
 
Cushings syndrome
Cushings syndromeCushings syndrome
Cushings syndrome
 
Adrenal Disorders.ppt
Adrenal Disorders.pptAdrenal Disorders.ppt
Adrenal Disorders.ppt
 
Primary hyperaldosteronism
Primary hyperaldosteronismPrimary hyperaldosteronism
Primary hyperaldosteronism
 

Ähnlich wie Adrenal gland disorders

Adrenocortical hormones edited
Adrenocortical hormones editedAdrenocortical hormones edited
Adrenocortical hormones editedAbdelNourBawadekji
 
adrenal disorder power point presentation
adrenal disorder power point presentationadrenal disorder power point presentation
adrenal disorder power point presentationNarayanNeupane3
 
Adrenal_insufficiency_.pptx
Adrenal_insufficiency_.pptxAdrenal_insufficiency_.pptx
Adrenal_insufficiency_.pptxMd Afgan Sk
 
Endocrine Disorder (Cushing's syndrome)
Endocrine Disorder (Cushing's syndrome)Endocrine Disorder (Cushing's syndrome)
Endocrine Disorder (Cushing's syndrome)Home Alone
 
Dental Management of Patient With Adrenal Cortex Disorder
Dental Management of Patient With Adrenal Cortex Disorder Dental Management of Patient With Adrenal Cortex Disorder
Dental Management of Patient With Adrenal Cortex Disorder Tarek Zaid
 
Cushingssyndrome 160827080057
Cushingssyndrome 160827080057Cushingssyndrome 160827080057
Cushingssyndrome 160827080057amnehmeno
 
CUSHING SYNDROME
CUSHING SYNDROMECUSHING SYNDROME
CUSHING SYNDROMERojarani42
 
Cushing's syndrome
Cushing's syndromeCushing's syndrome
Cushing's syndromeReem Alyahya
 
410270bbbbbbbbbbbbbbbbbbbbbbbbbhhbbbbb1.ppt
410270bbbbbbbbbbbbbbbbbbbbbbbbbhhbbbbb1.ppt410270bbbbbbbbbbbbbbbbbbbbbbbbbhhbbbbb1.ppt
410270bbbbbbbbbbbbbbbbbbbbbbbbbhhbbbbb1.pptssusere641521
 
Disorders of adrenal glands
Disorders of adrenal glandsDisorders of adrenal glands
Disorders of adrenal glandsRakhiYadav53
 
Adrenal Gland Tumours and their Management
Adrenal Gland Tumours and their ManagementAdrenal Gland Tumours and their Management
Adrenal Gland Tumours and their ManagementFaisal Zia
 

Ähnlich wie Adrenal gland disorders (20)

Cushing Syndrome
Cushing SyndromeCushing Syndrome
Cushing Syndrome
 
Adrenocortical hormones edited
Adrenocortical hormones editedAdrenocortical hormones edited
Adrenocortical hormones edited
 
adrenal disorder power point presentation
adrenal disorder power point presentationadrenal disorder power point presentation
adrenal disorder power point presentation
 
Adrenal_insufficiency_.pptx
Adrenal_insufficiency_.pptxAdrenal_insufficiency_.pptx
Adrenal_insufficiency_.pptx
 
adrenal tumor.pptx
adrenal tumor.pptxadrenal tumor.pptx
adrenal tumor.pptx
 
cushing syndrome-2.pdf
cushing syndrome-2.pdfcushing syndrome-2.pdf
cushing syndrome-2.pdf
 
Endocrine Disorder (Cushing's syndrome)
Endocrine Disorder (Cushing's syndrome)Endocrine Disorder (Cushing's syndrome)
Endocrine Disorder (Cushing's syndrome)
 
Dental Management of Patient With Adrenal Cortex Disorder
Dental Management of Patient With Adrenal Cortex Disorder Dental Management of Patient With Adrenal Cortex Disorder
Dental Management of Patient With Adrenal Cortex Disorder
 
addison disease-Lec.pptx
addison disease-Lec.pptxaddison disease-Lec.pptx
addison disease-Lec.pptx
 
Cushingssyndrome 160827080057
Cushingssyndrome 160827080057Cushingssyndrome 160827080057
Cushingssyndrome 160827080057
 
Cushing Syndrome
Cushing SyndromeCushing Syndrome
Cushing Syndrome
 
CUSHING SYNDROME
CUSHING SYNDROMECUSHING SYNDROME
CUSHING SYNDROME
 
Gout
GoutGout
Gout
 
Addison disease
Addison diseaseAddison disease
Addison disease
 
Cushing's syndrome
Cushing's syndromeCushing's syndrome
Cushing's syndrome
 
cushing syndrome-5.pdf
cushing syndrome-5.pdfcushing syndrome-5.pdf
cushing syndrome-5.pdf
 
410270bbbbbbbbbbbbbbbbbbbbbbbbbhhbbbbb1.ppt
410270bbbbbbbbbbbbbbbbbbbbbbbbbhhbbbbb1.ppt410270bbbbbbbbbbbbbbbbbbbbbbbbbhhbbbbb1.ppt
410270bbbbbbbbbbbbbbbbbbbbbbbbbhhbbbbb1.ppt
 
Disorders of adrenal glands
Disorders of adrenal glandsDisorders of adrenal glands
Disorders of adrenal glands
 
Adrenal Gland Tumours and their Management
Adrenal Gland Tumours and their ManagementAdrenal Gland Tumours and their Management
Adrenal Gland Tumours and their Management
 
adrenal disorder.pptx
adrenal disorder.pptxadrenal disorder.pptx
adrenal disorder.pptx
 

Kürzlich hochgeladen

ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptPradnya Wadekar
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfDolisha Warbi
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfHongBiThi1
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxkomalt2001
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfHongBiThi1
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 

Kürzlich hochgeladen (20)

ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologyppt
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptx
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
Biologic therapy ice breaking in rheumatology, Case based approach with appli...
Biologic therapy ice breaking in rheumatology, Case based approach with appli...Biologic therapy ice breaking in rheumatology, Case based approach with appli...
Biologic therapy ice breaking in rheumatology, Case based approach with appli...
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 

Adrenal gland disorders

  • 1. ADRENAL GLAND DISORDERS
  • 2. INTRODUCTION • Each person has 2 adrenal glands • 2 separate glands with independent function • Hypofunction and hyperfunction of adrenal cortex
  • 3. REVIEW OF ANATOMY AND PHYSIOLOGY Adrenal gland Cortex medulla
  • 4. Adrenal cortex Glucocorticoids mineralocorticoids sex Hydro cortisone corticosterone
  • 6. ADISSONS DISEASE DEFINITION: Inadequate secretion of ATCH from pitutary gland results adrenal in sufficiency . Primary adrenal insufficiency results from idiopathic atropy or destruction of adrenal glands by autoimmune process.
  • 7. ETIOLOGY AND RISK FACTORS • Tuberculosis (TB) :TB is an infection which usually affects the lungs. In some cases the infection can spread to, and gradually destroy, the adrenals • Other infections can sometimes affect both adrenals. • Cancers of other parts of the body can spread and destroy the adrenals. • Rare hereditary conditions. • adrenalectomy • Auto immune diseases: auto-immune diseases the immune system makes antibodies against part or parts of the body. In auto-immune Addison's disease, you make antibodies which attach to cells in the adrenal cortex
  • 8. CLINICAL MANIFESTATION • General weakness and becoming easily tired. • Darkened areas of skin ('pigmentation'). • Blood pressure is low and falls further when you stand which can make you dizzy. • Being off your food and weight loss. • Feeling sick and vomiting from time to time. • Abdominal pains which may come and go. • Diarrhoea or constipation which may come and go. • Cramps and pains in muscles. • Craving for salt, or salty foods and drinks. • Menstrual periods in women may become irregular, or stop.
  • 9. DIAGNOSTIC TESTS • Serum electrolyte levels • Blood glucose levels • CBC • X ray studies • Computed tomography • MRI
  • 10. TREATMENT • Cortisol replacement • You need steroid medication to replace the cortisol which you no longer make. This is usually with a medicine called hydrocortisone which is very similar to cortisol. The amount is usually about 15-25 mg each day. Some people need more than this, and others less. The daily amount is broken up into two or three doses each day with a higher dose taken in the morning than in the evening. For example, you may be advised to take 15 mg in the morning and 10 mg early evening.
  • 11. • Replacing aldosterone Fludrocortisone is a substitute medicine for aldosterone. This helps to regulate blood pressure and blood salt level. You may also be advised to take extra salt each day. • Addisonian crisis • This is a medical emergency. You will be given hydrocortisone injections, a 'drip' of fluid to bring up your blood pressure, and may need intensive care until the crisis is over. then need to continue taking hydrocortisone medication
  • 12. CUSHING SYNDROME • DEFINITION:. Cushing's syndrome develops when the level of a glucocorticoid in your body is too high over a long period of time. Too much glucocorticoid can occur from an exogenous or endogenous source
  • 13. ETIOLOGY • Adrenal hyperplasia - which means there is increased number and growth of the cells in the adrenal glands. These cells then make too much cortisol. There are various different types of adrenal hyperplasia. • A benign (noncancerous) tumour of an adrenal gland. • A malignant (cancerous) tumour of an adrenal gland
  • 14. SIGNS AND SYMPTOMS • Obesity - • Facial puffiness, and the face often looks redder than usual. • Diabetes. • Facial hair in women. • High blood pressure. • Muscle weakness. • Thin skin which bruises easily. • Purple/pink stretch marks • Tiredness. • Aches and pains - particularly backache. • Mood swings - such as being more irritable, depressed, or anxious than usual. • Lack of sex drive (libido). • Periods may become irregular, or stop, in women. • Osteoporosis . You may fracture a bone more easily than usual. • Oedema around the ankles.
  • 15. DIAGNOSTIC TESTS • Serum cortisol levels • Salivary cortisol levels • ACTH Level • ACTH Test • Pituitary MRI
  • 16. TREATMENT • Radiotherapy to the pituitary gland can destroy the pituitary adenoma. This has a good chance of success, but may take months or years to take effect. Medication (see below) may be needed until the radiation treatment takes effect. Also, the radiotherapy may damage the normal pituitary cells, and may cause low levels of other hormones made by the pituitary gland. However, replacement hormone therapy can usually be taken if this occurs. • Surgery to remove both adrenal glands is an option. This stops your body making any cortisol (and other hormones) from your adrenal glands. You will need lifelong replacement therapy of certain hormones. However, the adenoma will remain in the pituitary and continue to produce high levels of ACTH which can cause problems in some cases. • Medication to block the production or effects of cortisol may work. There are several medicines which can be tried with various levels of success.
  • 17. PHEOCHROMACYTOMA DEFINITION: Pheochromacytoma is a catecholamine secreting tumor of the cromaffin cells of the sympathetic nervous system it is usually found in the adrenal medulla.
  • 18. SYMPTOMS • Abdominal pain • Chest pain • Irritability • Nervousness • Pallor • Palpitations • Rapid heart rate • Severe headache • Sweating • Weight loss
  • 19. DIAGNOSTIC TESTS • Abdominal CT scan • Adrenal biopsy • Catecholamines blood test • Glucose test • Metanephrine blood test • MIBG scintiscan • MRI of abdomen • Urine catecholamines
  • 20. TREATMENT • Treatment involves removing the tumor with surgery. It is important to stabilize blood pressure and pulse with medication before surgery. close monitoring of vital signs. • After surgery, it is necessary to continually monitor all vital signs in an intensive care unit. When the tumor cannot be surgically removed, medication is needed to manage it. This usually requires a combination of medications to control the effects of the excessive hormones. Radiation therapy and chemotherapy have not been effective in curing this kind of tumor.
  • 21. NURSING MANAGEMENT • Risk for injury related to weakness • Risk for infection related to altered protein metabolism • Self care deficit related to fatigue and muscle wasting • Altered body image related to tunical obesity
  • 22. Corticotropin-Releasing Factor Test in Normal Subjects and Patients with Hypothalamic-Pituitary-Adrenal Disorders* • Corticotropin-releasing factor (CRF) tests were performed in normal subjects and patients with hypothalamicpituitary-adrenal disorders. In normal subjects, after iv administation of 500 μg synthetic ovine CRF, plasma ACTH rose significantly to approximately 3.6 times the basal level at 30–60 min and cortisol reached a peak of 2.3 times the basal level at 60–90 min, whereas aldosterone peaked at 1.6 times the basal level at 60 min. Injection of 100 μg CRF in normal subjects also caused a significant increase in plasma ACTH and cortisol levels but only a slight increase in aldosterone. However, the total hormone released and their peak levels were lower than those elicited by the 500-μg dosage. In patients with Cushing’s disease, although the basal and peak levels of plasma ACTH and cortisol induced by administration of CRF were variable, the ratios of increase for the two hormones elicited by CRF were lower than those in normal subjects, especially for cortisol. In patients with Cushing’s syndrome due to an adrenal adenoma, basal levels of ACTH were markedly suppressed and plasma ACTH and cortisol did not rise after CRF. In patients with isolated ACTH deficiency or Sheehan’s syndrome the basal level of plasma ACTH was less than 5 pg/ml and no change in plasma ACTH occurred after injection of CRF. In patients with Nelson’s syndrome or Addison’s disease the basal levels of ACTH were extremely elevated but infusion of CRF increased plasma ACTH to even higher levels.
  • 23. presented by, samantha 14/4/2012