ACTH Flashcards

1
Q

What is the prohormone of ACTH and the target organ for it?

A

Prohormone: pro-opiomelanocortin (POMC)
Target organ: the adrenal cortex

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2
Q

What is the function of ACTH?

A

Controls the production and secretion of cortisol and other glucocorticoids

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3
Q

List 4 functions of glucocorticoids

A

Protein breakdown - increase the rate of protein breakdown in the muscles to release amino acids.
Glucose formation - liver converts amino acids to glucose
Lipolysis - stimulate the breakdown of triglycerides to release fatty acids
Resistance to stress. Anti-inflammatory effects.

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4
Q

What are some symptoms of cushing syndrome?

A

Unexplained central obesity, stretch marks, osteoporosis, weakness, hypertension, moon faces and a buffalo hump.

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5
Q

What are some tests that can determine Cushing syndrome?

A

Plasma ACTH, Metyrapone stimulation test, Inferior petrosal sinus sampling.

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6
Q

What can be done to treat cushing syndrome?

A

Normalise cortisol levels, monitor and treat cortisol-dependent comorbidities. Vaccinate against influenza, herpes zoster. Surgical resection of primary adrenal ectopic focus underlying CS.

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7
Q

What is the mainstay of treatment?

A

Removal of the tumour. Using agents like metyrapone and ketoconazole, an adrenal enzyme blocker. Also inhibits gonadal steroidogenesis

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8
Q

What is the function of pasireotide in cushing disease?

A

Its a long somatastatin analogue and it suppresses ACTH secretion which may lead to reduction of cortisol secretion.

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9
Q

What causes adrenocortical insufficiency?

A

May be caused by deficient adrenal production of gluco and mineralcorticoids.
Dysfunction may be due to addison disease or secondary adrenocortical insufficiency.

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10
Q

What are some symptoms of addisons disease?

A

Fatigue, weakness, anorexia, N&V

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11
Q

What are some differences between addison disease and secondary adrenal insufficiency?

A

Addison’s disease: Hyperpigmentation, abnormal response to short corticotropin stimulation test. ACTH levels are elevated.

Secondary adrenal insufficiency:
Hypopigmentation, a normal corticotropin stimulation test. Low ACTH levels.

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12
Q

What is the treatment for Addison Disease?

A

Hydrocortisone and cortisone acetate. Mimic endogenous cortisol production. Administer 67% of the dose in the morning and the remainder is given 6-8 later.

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13
Q

What are some adverse effects of glucorticosteroids?

A

Growth inhibition in children, muscle wasting, osteoporosis, salt retention, depression, psychosis.

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