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endocrine S. Horvath > adrenal > Flashcards

adrenal Flashcards

1
Q

Adrenal glands are also called

A

suprarenal

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2
Q

adrenal medulla is connected directly to the SNS via

A

nerves

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3
Q

the adrenal medulla releases

A

catcholamines

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4
Q

T/F Catecholamines are made by chromaffin cells in the adrenal medulla

A

TRUE

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5
Q

catecholamines are all derived from

A

tyrosine

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6
Q

what are the 4 catecholamines

A

DOPA, dopamine, norepinephrine, epi

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7
Q

what is the principal product of the adrenal medulla

A

epi

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8
Q

T/F Epi is made only in the adrenal medulla

A

TRUE

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9
Q

Epi accounts for nearly ___of the adrenal medulla’s output, the other ___ is norepinephrine, and a scant amt of ___ is also made here

A

80%, 30, dopamine

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10
Q

fight or flight - decreased blood flow to ___, ___ and ____

A

kidneys, skin, mucosa

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11
Q

epi and norepinephrine both have strong ____ effects which result in arterial vasoconstriction

A

alpha-1

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12
Q

epi has stronger ____ which increases HR and contractility more

A

beta1

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13
Q

___ is an enzyme necessary for conversion of norepinephrine to epi

A

PNMT

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14
Q

T/F: PNMT is regulated by serotonin

A

False - regulated by glucocorticoids (cortisone)

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15
Q

T/F: Pheochromocytoma is a tumor caused by adrenal medullary hyperplasia or extra-adrenal chromaffin tissue

A

TRUE

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16
Q

s/s of Pheochromocytoma

A

paroxysmal htn, tachycardia, HA, sweating, anxiety, tumor, glucose intolerance

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17
Q

Most tumors (85-90%) are solitary tumors localized to a single adrenal gland (mostly the ____)

A

right

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18
Q

__ of tumors are extra-medullary, of these __ are in the abdomen

A
  1. 95
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19
Q

____ levels help to make the diagnosis of Pheochromocytoma as both epi and norepinephrine are degrade to this

A

Urinary VMA

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20
Q

___blockers com before ___ blockers for surgery in pt with Pheochromocytoma

A

alpha, beta

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21
Q

start a-blockers ___ days prior to surgery

A

10-14

22
Q

why is beta blockade delayed?

A

the risk of unopposed alpha mediated vasoconstriction

23
Q

Pheochromocytoma use ___ acting vasoactive agents

A

short-acting

24
Q

which drugs release histamine and provoke Pheochromocytoma

A

reglan and glucagon

25
Q

T/F Catecholamine levels return to normal several days after surgery and approx ___% of patients become normotensive within __ days post-op

A

75, 10

26
Q

T/F the physiologic effect of medullary hypo secretion is not a serious problem

A

TRue

27
Q

adrenal cortex produces ___ and ____ and is a secondary site of ___ synthesis

A

mineralocorticoids , glucocorticoids, androgen

28
Q

the zona glomerulosa produces ____

A

mineralocorticoids

29
Q

the zona fasciculata produces ____

A

glucocorticoids

30
Q

zona reticulatis produces ____

A

androgens

31
Q

what is the primary mineralcorticoid

A

aldosterone

32
Q

what is the primary glucocorticoid

A

cortisol

33
Q

what is the primary androgen

A

aldosterone

34
Q

T/F all of the hormones of the adrenal cortex are steroid hormones, all are synthesized from cholesterol

A

TRUE

35
Q

aldosterone causes retention of ___ and excretion of ____

A

retention of sodium and water, excretion of K and H+

36
Q

T/F if unopposed, aldosterone leads to hypertension, ECF expansion, hyperkalemia, and acidosis

A

FALSE - hypokalemia and alkalosis

37
Q

T/F ACTH and Na levels don not exert much control over the release of aldosterone

A

TRUE

38
Q

Conn’s syndrome is a form of ___ hyperaldosteronism which causes ___ ECF Volume, ___tension, K+ ____ and what acid base disturbance?

A 
Conns:
primary hyperaldo
increased ECF volume
htn
K+ depletion
metabolic alkalosis
39
Q

what causes conn’s

A

aldosterone secreting tumors or hyperplasias

40
Q

T/F Secondary hyperaldosteronism is caused by CHF, cirrhosis with ascites, and nephrosis

A

TRUE (ECF lost to extravascular space)

41
Q

hypoaldosteronism is caused by ____. __ is lost in the urine and __ is retained.

A

adrenal insufficiency
na
k

42
Q

hypoaldosteronism- plasma volume ___ and hypotension/hyper___ may lead to circulatory collapse

A

decreases, hyperkalemia

43
Q

T/F muscles can become weak in great cortisol deficiency

A

FALSE - cortisol excesses

44
Q

___ levels of cortisol have anti-inflammatory effects

A

high

45
Q

ACTH release is controlled by ___ from the hypothalamus

A

CRH

46
Q

T/F High Cortisol levels cause inhibition of ___ and ___ release

A

ACTH , CRH

47
Q

cortisol is a ___ feedback system

A

negative

48
Q

Cushing disease vs syndrome

A

dz: ACTH secreting tumor of the pituitary
syndrome: excessive cortisol secretion

49
Q

T/F: Addison’s dz results from failure to produce adrenocortical hormones

A

TRUE

50
Q

T/F etomidate causes profound suppression of cortisol for at least 24h and can contribute to adrenal insufficiency and resultant hypotension

A

TRUE

51
Q

T/F etomidate causes profound suppression of cortisol for at least 24h and can contribute to adrenal insufficiency and resultant hypotension

A

TRUE

52
Q

T/F Etomidate should be used sparingly in patients with septic shock

A

TRUE

endocrine S. Horvath (6 decks)

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