Steroids

Question 1

Name some corticosteroids

Answer 1

Prednisone
Prednisolone
Dexamethasone
Hydrocortisone

Question 2

What is Cushing’s Syndrome? What are the symptoms?

Answer 2

Constantly high levels of cortisol
leads to:
* severe muscle, bone and skin breakdown -> muscle wasting and thin extremities
* elevated blood glucose -> insulin -> central obesity
* hypertension - inc. effect of catecholamines on blood vessels and cortisol cross-react with mineralcorticoid receptors
* inhibits GTRH leading to ovarian and testicular dysfunction
* dampens immune response -> amenorrhea
* Impairs normal brain function -> psychiatric mental disturbances

Question 3

What is Addison’s disease? What are the symptoms?

Answer 3

Primary adrenal insufficiency: Adrenal cortex is proggressively damaged.
symptoms related to layer affected.
* Zona Glomerulosa: Aldosterone falls -> hyperkalemia, hyponatremia, hypovolemia, and acidosis -> nausea, vomiting, fatigue, dizziness, and craving salty foods
* Zona Fasciculata: cortisol falls -> low blood glucose when stressed -> weak, tired, disoriented
Overactive pituitary gland -> hyperpigmentation
* Zona Reticularis: Androgen falls -> (in women) decreased sex drive and loss of pubic hair.

Question 4

What is Conn’s syndrome? What are the symptoms?

Answer 4

Primary Aldosteronism: A condition where adrenal glands produce too much aldosterone.
* diastolic hypertension
* hypokalaemia
* Polyuria
* muscle weakness
* polydipsia
* fatigue
* difficulty concentrating
* increased renin

Question 5

What are the potential complications of Adison’s Disease?

Answer 5

Addisonian crisis:
* pain in lower back, abdomen or legs
* vomiting and diarrhoea -> dehydration
* low BP -> loss of conciousness
* death

Question 6

What are the potential complications of Cushing’s Syndrome?

Answer 6

Type 2 Diabetes
Fractures from Osteoporosis
Increased risk of cardiovascular disease
Increased vulnerability to infection
Poor wound healing

Question 7

How is Cushing’s Syndrome treated?

Answer 7

Exogenous cause: taper off the current steroid treatment
Endogenous:
Surgically remove pituitary adenoma
Adrenal steroid inhibitors: Ketoconazole & Metyrapone

Question 8

How is Addison’s disease treated?

Answer 8

Steroids to replace cortisol, aldosterone and androgens
Taken for life

Question 9

How is Conn’s Syndrome treated?

Answer 9

Surgically remove tumour causing aldosteronism
Medication:
aldosterone antagonist: Spironolactone and elperenone