Glucocorticoids

-

Today I made up a mnemonic for remembering the effects of excessive glucocorticoids: 

"Grossly Fat Pigs Can Never Ice-skate Harmlessly"

Cows however.... 


  • Grossly  Glucose - reduced glucose uptake by cells and increased gluconeogenesis leads to relatively high blood glucose, which leads to increased insulin secretion and glycogen production. This may cause diabetes. 
  • Fat - Fat - Fat is redistributed to the abdomen and face (moon face) and the back of the neck (buffalo hump)
  • Pigs - Protein - there is increased protein breakdown and decreased buildup leading to muscle wasting. 
  • Can - Calcium - increased osteoclastic activity and reduced osteoblast activity leads to osteoporosis. There is also reduced absorption in the gut and increased secretion by the kidneys. 
  • Never - Negative feedback - causes negative feedback on ACTH(unless increased ACTH is the primary cause) - synthetic glucocorticoids may lead to a reduced production of endogenous glucocorticoids 
  • Ice Skate - Inflammation supression - reduces both acute and chronic inflammation and scarring. Also affects blood vessesls. 
  • Harmlessly- Healing - this also affects healing- patients have poor wound healing, thin skin, easy bruising and may have avascular necrosis of the femoral head due to its effects on blood vessels. 
  • Other side effects of synthetic glucocorticoids include hypertension, euphoria or depression, cataracts, benign intracranial hypertension, hypercoagulability, menstural disorders, and oral thrush.. I haven't figured out how to include these in yet. 
Also cushing's syndrome refers to the symptoms seen in patients with prolonged exposure to excessive corticosteroids (may be endogenous or exogenous and caused by problems of the pituitary or the adrenal gland itself), whereas cushing's disease refers to disease of the pituitary gland leading to excessive adenocorticotrophic hormone production causing excessive cortisol. 

References:
http://www.patient.co.uk/doctor/cushings-syndrome
Kumar and Clark's clinical medicine

Comments

Post a Comment

Popular posts from this blog

Pleural effusion

-
Image
Definition Pleural effusion is a collection of fluid in the pleural space between the visceral pleura surounding the lungs and the parietal pleural attatched to the throacic wall. Demographics Pleural effusions are relatively common, but it is a manifestation of other underlying diseases. The prevalence and incidence of pleural effusions is therefore dependent on it's cause. Pathophysiology/causes Pleural fluid is usually filtered from the parietal pleura into the pleural space, due to hydrostatic pressure from the capillaries, negative pressure in the pleural space and pleural oncotic pressure. The visceral pleura is perfused by the pulmonary system which has a lower pressure, and fluid in the pleural space is therefore drawn back in through the visceral pleura due to the higher oncotic pressure in plasma. Some of this fluid is then drained by the lymphatic system.
Read more

Describing skin lesions

-
Image
Describing lesions  Site, Distribution and symmetry Type of lesion Size Shape - edges, well demarcated? regular/irregular shape? Surface -color and texture, scaly vs non-scaly (epidermis lesions are scaly) Special features - fluid filled?, mobility, temperature/inflammation, other features.
Read more

Fluid Management Part 1

-
Image
Fluid compartments:   The body is made of about 60% water, which is divided between the intracellular and extracellular space. Fluid is distributed in these spaces by osmotic forces determined by ion distribution between the intracellular and extraceullular space. Approximately 2/3rds (40% total body weight) of the body’s fluids is distributed in the intracellular space and 1/3rd (20%)in the extracellular space.
Read more