15.10 - Adrenal cortex Flashcards
aldosterone works on what cells of the tubule?
- principal cells
- alpha intercalated cells
how does hyperaldosteronism present?
- HTN
- hypokalemia
- metabolic alkalosis
how does aldosterone affect potassium and protons?
secretes potassium and protons in the distal tubule and collecting duct
why is edema absent in hyperaldosteronism?
aldosterone escape
what is the first line treatment for primary hyperaldosteronism?
mineralocorticoid receptor antagonis (spironolactone, eplerenone)
what is the cause of liddle syndrome? how does it present?
- decreased degradation of sodium channels in collecting tubules
- young patient
- HTN
- hypokalemia
- metabolic alkalosis
- low aldosterone
- low renin
what is the treatment of liddle syndrome?
potassium sparing diuretics (amiloride, triamterene)
**spironolactone is not effective
what is the inheritance of liddle syndrome?
AD
in cushing sydrome, what are the levels of:
- BP
- potassium
- pH
- HTN
- hypokalemia
- metabolic alkalosis
by what 3 mechanisms does hypercortisolism cause immune suppression?
- inhibits phospholipase A2 (no arachadonic metabolites)
- inhibits IL-2 (T cell growth receptor)
- inhibits histamine from mast cells
- hyponatremia
- hyperkalemia
- hypovolemia (hypotension)
- ambiguous genitalia in females
21-hydroxylase deficiency
- HTN
- mild hypokalemia
- low renin
- low aldosterone
11-hydroxylase deficiency
- HTN
- mild hypokalemia
- low renin
- low aldosterone
- decreased androgens (primary amenorrhea, lack of pubic hair in females, pseudohermaphroditism in males)
17-hydroxylase deficiency
screening for CAH involves serum ________________ levels
17-OH progesterone
- hypotension
- hyponatremia
- hypovolemia
- hyperkalemia
- metabolic acidosis
- weakness
- hyperpigmentation
- vomiting
- diarrhea
primary adrenal insufficiency (addison disease)
