Home 
Contact 
Profile 
Videos 
Lecture
by for 4th year medical students on December 24, 2013 by Prof Omar
Hasan Kasule Sr.
Types
of adrenal steroids
·
Glucocorticoids: act on
carbohydrate metabolism
·
Mineralocorticoids: Na, K, and
fluid balance in distal kidney tubules
·
Androgens: converted to
testosterone
Addison
disease (primary hypoadrenalism) 1
·
Causes: autoimmune,
infiltration, TB, surgical removal, hemorrhage/infarction, infiltration
·
Effects: Impaired glucocorticoid,
mineralocorticoid, and androgen production
Addison
disease (primary hypoadrenalism) 2
·
Symptoms: weight loss,
anorexia, malaise, fever, weakness, depression, impotence/amenorrhoea,
nausea/vomiting, diarrhea, constipation, confusion, syncope, abdominal pain,
myalgia, joint pain
·
Signs: pigmentation,
postural hypotension, weight loss, muscle wasting, dehydration, loss of body
hair
Cushing’s
syndrome (increased circulating glucocorticoids) 1
·
Causes: (a) increased ACTH from pituitary, ectopic
tumors, or drug administration (b) adrenal adenoma / carcinoma (c) iatrogenic
glucocorticoid administration
·
Symptoms: weight gain,
changed appearance, depression, insomnia, amenorrhea/oligomenorhea, poor
libido, thin skin easy to bruise, acne, muscle weakness, back pain,
polyuria/polydipsia, psychosis
Cushing’s
syndrome (increased circulating glucocorticoids) 2
·
Signs: short stature,
moon plethoric face, depression/psychosis, acne, hirsuitism, thin bruising
skin, poor wound healing, pigmentation, skin infections, systemic hypertension,
osteoporosis, pathological fractures, Kyphosis due to osteoporosis, truncal / central obesity (buffalo hump),
abdominal striae, rib fractures, proximal muscle weakness