Cushing’s Syndrome 2. Addison’s Disease Feature Dexamethasone Suppression Test Synacthen Test Purpose To assess adrenal suppression and identify causes of Cushing’s syndrome (e.g., pituitary vs. adrenal cause). To evaluate adrenal gland function, specifically assessing adrenal response to ACTH to diagnose adrenal insufficiency. Mechanism Administers dexamethasone (a glucocorticoid) to suppress ACTH…

Adrenal Insufficiency can be defined Real, Iatrogenic, and Imagined 1. Real (Primary and Secondary) Adrenal Insufficiency 2. Iatrogenic Adrenal Insufficiency 3. Imagined (Functional) Adrenal Insufficiency Symptoms: Nb: if the cause of adrenal cortex deficiency is due to ACTH deficiency, then will have no pigmentation & will have less postural hypotension/…

Circadian rhythms & stress 🡪  CNS higher centres (NA, ACH, 5HT) 🡪 Hypothalamus (CRH) 🡪 Anterior pituitary (ACTH) 🡪 Adrenal cortex fasciculata (cortisol) Symptoms Clinical Features of Cushing’s Syndrome: DIAGNOSIS: Management

(Conn’s syndrome – both hyper-secretions are “C” diseases – cf. Cushing’s) Causes:  clinical features: Differentials for Hypertension with Hypokalemia Labs Factors affecting the aldosterone-to-renin ratio (ARR) Causes of false-positive ARR Beta-blockerCentral agonists (clonidine, α-methyldopa)Nonsteroidal anti-inflammatory drugsLicoriceRenal impairmentOral oestrogens Causes of false-negative ARR DiureticsDihydropyridine calcium channel blockersAngiotensin-converting enzyme inhibitors and angiotensin…

the adrenal gland is made up of the outer cortex & inner medulla  arterial supply comes from the inferior mesenteric artery & renal arteries as well as the aorta venous drainage of the L is via the L renal vein but the R drains directly into the IVC CORTEX 3…