ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.
-
Upload
loreen-douglas -
Category
Documents
-
view
224 -
download
0
Transcript of ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.
![Page 1: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/1.jpg)
![Page 2: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/2.jpg)
ENDOCRINOLOGY
ADRENAL CORTEX
DR SYED SHAHID HABIB
MBBS FCPS DSDM
![Page 3: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/3.jpg)
![Page 4: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/4.jpg)
![Page 5: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/5.jpg)
![Page 6: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/6.jpg)
CORTEX
ZONAGLOMERULO
SA
MINERALOCORTICOIDS (ALDOSTERONE)
ZONAFASICULATA
GLUCOCORTICOIDS (CORTISOL)
PREDOMINANTLY
ZONARETICULARIS
ANDROGENS (DEHYDROEPIANDROSTE
RONE)PREDOMINANTLY
MEDULLACATECHOLAMINES (EPINEPHRINE AND NOREPINEPHRINE)
![Page 7: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/7.jpg)
Class of SteroidMajor
RepresentativePhysiologic Effects
Mineralocorticoids AldosteroneNa+, K+ and water
homeostasis
Glucocorticoids CortisolGlucose
homeostasis and many others
AndrogensDehydroepiand
rosteroneAndrogenic
Activity
![Page 8: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/8.jpg)
TWO TO THREE DOZEN
![Page 9: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/9.jpg)
• Source Primarily zona fasiculata• Chemistry C21 Cortico Steroid• Half Life 60-90 min• Fate Conjugated in Liver and then Excreted in urine or bile. • Transport Only about 10% free & 90 % bound to corticosteroid-binding globulin (transcortin)
Cortisol
![Page 10: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/10.jpg)
MECHANISM OF ACTION
R
Transformation of Receptor to expose
DNA binding Domain
Binding to Enhancer like Segment in DNA
Pre mRNA
mRNA
mRNA
Protein
R
EFFECTS
![Page 11: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/11.jpg)
PHYSIOLOGIC EFFECTS OF GLUCOCORTICOIDS
EFFECTS ON INTERMEDIARY METABOLISM
CARBOHYDRATES
FATS
PROTEINS
![Page 12: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/12.jpg)
PHYSIOLOGIC EFFECTS OF GLUCOCORTICOIDS
EFFECTS ON METABOLISM
• Catabolic proteolytic action: Mobilization of amino acids from extrahepatic tissues: These serve as substrates for gluconeogenesis
• Gluconeogenesis, Glycogenesis and Anti Insulin Action Inhibition of glucose uptake in muscle and adipose tissue
• Lipolytic Action Stimulation of fat breakdown in adipose tissue: The fatty acids released by lipolysis are used for production of energy in tissues like muscle
![Page 13: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/13.jpg)
EFFECTS ON INFLAMMATION AND IMMUNE FUNCTION
• Glucocorticoids have potent anti-inflammatory and immunosuppressive properties.
PHYSIOLOGIC EFFECTS OF GLUCOCORTICOIDS
OTHER EFFECTS OF GLUCOCORTICOIDS• Glucocorticoids have multiple effects on FETAL
DEVELOPMENT (maturation of the lung and production of the surfactant necessary for extrauterine lung function)
![Page 14: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/14.jpg)
Physiologic Effect Clinical expressionCortisol Deficiency
Cortisol exces
CARBOHYDRATE METABOLISM• Increased gluconeogenesis• Decreased glucose utilization
Hypoglycemia hyperglycemia
• Decreased sensitivity to insulin
Increased Insulin sensitivity
Insulin resistance
PROTEIN METABOLISM• Decreased extrahepatic
amino acid utilization • Increased gluconeogenesis
Hypoglycemia Dec protein in bone, skin, muscle
Poor wound healing
FAT METABOLISM• Increased lipolysis, decreased
lipogenisis Weight loss Hyperlipemia
• Distribution of fat Truncal obesity
![Page 15: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/15.jpg)
DIURNAL VARIATION
![Page 16: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/16.jpg)
CORTISOL
CRH
ACTH
PhysicalStress
Mental stress
LIVERFATS
MUSCLEBLOOD CELLS
-
-
+
+
Phlebotomist
FEEDBACK CONTROL
OF CORTSOLSECRETION
Trauma Pain
Emotion
![Page 17: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/17.jpg)
![Page 18: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/18.jpg)
CUSHING’S SYNDROME
![Page 19: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/19.jpg)
![Page 20: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/20.jpg)
![Page 21: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/21.jpg)
![Page 22: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/22.jpg)
ALDOSTERONE
• Source Zona Glomerulosa• Chemistry Steroid• Half Life 20 min• Fate Conjugated in Liver and then Excreted in urine or bile. • Transport Only about 40% free & 60 % bound to Albumin
![Page 23: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/23.jpg)
WHAT ARE THE TARGETS OF ALDOSTERONE?
![Page 24: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/24.jpg)
ALDOSTERONE TARGETS
Renal tubules
Sweat Glands
Salivary glands
Gastrointestinal Tract
Increases Na Epithelial channels
![Page 25: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/25.jpg)
Effect Of Aldosterone On Cortical Collecting Duct
![Page 26: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/26.jpg)
MECHANISM OF ACTION
R
Transformation of Receptor to expose
DNA binding Domain
Binding to Enhancer like Segment in DNA
Pre mRNA
mRNA
mRNA
Protein
ENaCs
Na K Adenosine Triphosphatase
![Page 27: ENDOCRINOLOGY ADRENAL CORTEX DR SYED SHAHID HABIB MBBS FCPS DSDM.](https://reader035.fdocuments.in/reader035/viewer/2022062515/56649cd55503460f9499c925/html5/thumbnails/27.jpg)
Ushu