Adrenal Flashcards
What is synthesised and released from the zona glomerulosa?
Aldosterone in response to angiotensin II & K+
What is synthesised and released from the zona fasiculata?
Glucorticoids (i.e. cortisol) in response to ACTH
What is synthesised and released from the zona reticularis?
Sex hormones in response to ACTH & CASH
What are the effects of cortisol?
Anti-inflammatory.
Stimulates gluconeogenesis > increased blood glucose.
Stimulates catabolism of proteins > increased blood AAs.
Stimulates FA release > increased blood FAs.
What is Cushing’s syndrome?
Elevated plasma [cortisol]
Name some causes of Cushing’s
Cushing’s disease - adenoma of the AP.
Adenoma of the adrenal cortex.
Abnormal hypothalamus function > elevated CRH release.
LT treatment with glucocorticoids.
What affect will primary cushings syndrome have on ACTH levels?
ACTH levels will be reduced.
What affect will secondary cushings have on ACTH levels?
ACTH levels will be elevated.
How can you differentiate between primary and secondary cushings?
Give dexamethasone - if ACTH levels fall = secondary cushings.
What are the symptoms of cushings?
Weight gain & central obesity. Moon faced. Plethoric. Easily bruised. Hypertension.
What is the treatment for cushings?
Removal of adenoma.
11-beta hydroxylase inhibitor (metyrapone) - blocks 11-B hydroxylase which is required for cortisol synthesis.
Mitotane.
What is 21-hydroxylase deficiency?
Most common cause of CAH.
Autosomal recessive disorder which leads to 21 hydroxylase deficiency - required for cortisol & aldosterone synthesis.
What are the symptoms of 21-hydroxylase deficiency?
Hypotension.
Hypovolaemia.
Salt wasting.
Sexual ambiguity and hirsuitism.
What will investigations for 21-hydroxylase deficiency show?
Elevated 17 hydroxyprogesterone levels.
Low cortisol levels.
Elevated androgen levels.
What is the treatment for 21-hydroxylase deficiency?
Hydrocortisone
Fludrocortisone
