BCH 4123 Lecture Notes - Lecture 8: Small-Cell Carcinoma, Acth Stimulation Test, Adrenal Insufficiency
2 Feb 2017
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Anatomy: cortex synthesizes mineralocorticoids, glucocorticoids, and androgens from cholesterol. Lots of lipids (yellow colour) because of cholesterol. 3 layers that produce the three hormones (the deeper you go, the sweeter it gets) Presence of various enzymes and precursors produces each hormone. Deficiency of upstream enzyme will cause problems like congenital adrenal hyperplasia. Cortisol: overall increases blood glucose over long term. To fight a stressful challenge at hand. Can help modulate pain and stress in short term: anti-inflammatory, regulated by acth. Diurnal variation of acth highest in morning (5-10 ug/dl) Acth and cortisol negatively feeds back on crh production in hypothalamus: overproduction is tested with 24 hour free cortisol urine test. Hyperfu(cid:374)ctio(cid:374) (cid:894)cushi(cid:374)g"s sy(cid:374)dro(cid:373)e(cid:895: syndrome suggests multiple causes, cushi(cid:374)g"s disease. Most common (70%: ectopic acth syndrome. Tumour elsewhere that produces acth (20%: adrenal tumour. Thin skin with striae because of immunosuppressive properties: can cause hypertension as it acts on mineralocorticoid receptor, poor wound healing, hyperglycemia, weakness, screening.
