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Endocrinology > Adrenal > Flashcards

Adrenal Flashcards

1
Q

Which part of the adrenal gland produces steroid hormones?

A

The cortex! (CORTicoid) :)

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2
Q

What type of messenger does the adrenal medulla produce? What are the two examples?

A

Catecholamines…Epinephrine and NorEpi

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3
Q

What are the three layers of the adrenal cortex?

A

Zona Glomerulosa, Zona fasicula, Zona Reticularis

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4
Q

What are the three types of hormones produced in the adrenal cortex? What is an example of each?

A
  1. Minral-o-CORTicoid (Aldosterone) 2.Gluco-CORTicoid (Cortisol) 3.Androgens(DHEA)
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5
Q

Since the corticoids are hydrophobic how do they get around the blood?

A

Bound to protein carriers!

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6
Q

What type of stimulus causes CRH secretion from the hypothalamus to the pituitary?

A

Stress!

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7
Q

What “type” of rhythm is ACTH released? WHEN is ACTH most frequently released?

A

“Diurnal” (whatever that means), ACTH is released most from 4-6pm

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8
Q

What does cortisol do to blood glucose?

A

it INCREASES blood glucose (its a GLUCOcorticoid)

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9
Q

Does cortisol increase or resist insulin?

A

Cortisol causes insulin RESISTANCE

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10
Q

Does cortisol stimulate or inhibit appetite?

A

Cortisol Stimulates Appetite-causes weight gain (STRESS EATING!)

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11
Q

Does cortisol increase or decrease protein breakdown?

A

Increase!…breakdown proteins for GNG!

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12
Q

Does cortisol promote or inhibit glycogen storage in the liver?

A

Cortisol promotes liver glycogen storage

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13
Q

Does cortisol have any mineralcorticoid activity?

A

Yes, it helps retain sodium

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14
Q

How does cortisol affect our ability to handle stress?

A

Cortisol increases tolerance to stress

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15
Q

What effect does cortisol have on inflammation, immune response, and wound healing?

A

SUPRESSES ALL! (giving a cortisol shot to an injury can help (temporarily) but hope to God there isn’t an infection in the area

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16
Q

How does Aldosterone (a minralocorticoid) affect kidney excretion of sodium and potassium? What is the big picture result of this action?

A

Retains sodium! (decreases kidney excretion of sodium) and Increases kidney excretion of potsssium…Big picture: maintains blood volume and pressure

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17
Q

What is the main task of DHEA (a weak androgen-masculinizing hormone)?

A

Maintains axillary and poobic hair

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18
Q

What effect can excess DHEA have on females and young boys?

A

Virilization and hitsutism

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19
Q

What test would you order to measure adrenal insufficiency?

A

an ACTH stimulation test

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20
Q

What test would you order for pituitary insufficiency?

A

CRH Stimulation test

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21
Q

What test would you order for cortisol excess?

A

Dexa-metha-sone suppression test (Dexa is a glucocorticoid) Give at 11pm, ACTH SHOULD be suppressed by the morning (which it unusual). if not suppressed, something is wrong with ACTH production

22
Q

What can be the result of these problems?: Autoimmune destruction, Infection(TB,Cytomegalovirus, HIV), Metastatic cancer, hemorrhage, surgical removal

A

Primary Adrenal Insufficiency (like 98% of the adrenal gland has to be compromised for dysfunction)

23
Q

What is the big picture issue? specific issue? Weakness and fatigue, nausea, vomiting, weight loss, abdominal pain, low glucose, very ill even w/ minor illness

A

BIG: primary adrenal insufficiency SPECIFIC: low cortisol

24
Q

What is the big picture issue? Specific issue?: Low Sodium, high potassium, low blood pressure

A

BIG: primary adrenal insufficiency SPECIFIC: low aldosterone

25
Q

What is the big picture issue? Specific issue? Hyperpigmentation

A

BIG: primary adrenal insufficiency Specific: HIGH ACTH

26
Q

Review: which hormone stimulates melanin production?

A

ACTH (WTF?!)

27
Q

What is defined by: extreme weakness, nausea, vomiting, dehydration, hypotension, and hypogeycemia?

A

Acute adrenal crisis

28
Q

The following can cause? Undiagnosed adrenal disease, known adrenal disease + major stress, abrupt withdrawal of glucocorticoid therapy

A

acute adrenal crisis

29
Q

What result are we going to see with a secondary adrenal insufficiency? (ACTH level? cortisol level?)

A

Low ACTH, Low cortisol

30
Q

Do we see change in blood pressure or hyper pigmentation with secondary adrenal insufficiency?

A

NOPE, aldosterone mainly regulated by the kidneys, and HIGH ACTH causes hyper pig.

31
Q

How would you treat primary adrenal insufficiency?

A

Cortisol (Am, noon, illness in the form of fludrocortisone)

32
Q

How would you treat secondary adrenal insufficiency?

A

Cortisol

33
Q

What is Dexamethasone’s glucocorticoid potency? mineralcorticoid?

A

gluco: FREGGIN HUGE, minralo: neglegable

34
Q

What is the difference between Cushing’s disease vs Cushing’s Syndrome? What defines each?

A

Disease=excess cortisol from a PITUITARY tumor Syndrome=excess cortisol in general

35
Q

What is the source of cortisol excess from a non-pituitary tumor?

A

an Ectopic ACTH tumor

36
Q

Can there be a tumor in the adrenal gland that secretes excess cortisol?

A

YES

37
Q

Can you have excess cortisol from prescribed glucocorticoid for inflammatory conditions?

A

Absolutely!

38
Q

Cushing Syndrome: What are the levels of ACTH and cortisol for a pituitary tumor?

A

high ACTH and High Cortisol

39
Q

Cushing Syndrome: What are the levels of ACTH and cortisol for an Ectopic ACTH tumor?

A

High ACTH, High Cortisol

40
Q

Cushing syndrome: what are the levels of ACTH and cortisol with an ADRENAL TUMOR?

A

low ACTH, high Cortisol *unique, not sure I understand the reasoning here though..

41
Q

Cushing syndrome: what are the levels for ACTH and cortisol with excess exogenous cortisol?

A

low ACTH, high Cortisol

42
Q

What syndrome (and specific detail) can cause purple stretch marks, hyperglycemia, diabetes, easy bruising, weakness, moon face, weight gain, osteoporosis, growth failure in children? (2 ANSWERS)

A

Cushing Syndrome c/o Cortisol Excess

43
Q

Which of the four types of Cushing syndrome/disease is likely to cause high cortisol, high adrenal androgens, hitsutism, acne, high aldosterone, high bp, headache, visual disturbance?

A

A Pituitary Tumor producing ACTH! (the definition of Cushing’s DISEASE)

44
Q

What is the FIRST test to look for Cushing syndrome(high cortisol)?

A

Plasma or saliva cortisol @ MIDNIGHT (when its supposed to be low)

45
Q

WTF is DexaMethaSone?!

A

a synthetic glucocorticoid used to check high Cortisol levels. (Should suppress ACTH and cortisol if it does not, suspect a tumor)

46
Q

What type of tumors will not be suppressed with dexamethasone?

A

Ectopic ACTH producing tumors

47
Q

What is the first treatment for Cushing syndrome/disease? What is the second option? Can you reverse the effects?

A

Surgery! Get rid of that thing!…Second option treat w drugs. YES you can expect excellent resolution of signs and symptoms.

48
Q

What are the receptors for the adrenal medulla hormones?

A

alpha and beta adrenergic receptors (for Epi and NorEpi)

49
Q

In general will epi be catabolic or anabolic?

A

Catabolic, need energy to run!

50
Q

WTF is a PHEO-CHRO-MO-CYTOMA? What are some symptoms?

A

A catecholamine-secreting tumor of the adrenal medulla…Headache, sweating, palpitations

Endocrinology (8 decks)

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