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Endocrinology > Adrenal > Flashcards

Adrenal Flashcards

1
Q

Where are the adrenal glands located?

A

On top of kidneys

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2
Q

Histologically, what are the 3 layers of the adrenals?

A

capsule
cortex
medulla

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3
Q

what is the cortex made up of?

A

zona glomerulosa
zona fasciculata
zona reticularis

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4
Q

What regulates aldosterone secretion?

A

RAAS

Plasma K+

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5
Q

What is the clinical action of corticosteroids?

A

Suppress inflammation

suppress immune system

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6
Q

List disorders of the adrenal gland that are caused by primary insufficiency?

A

Addison’s

Congenital adrenal hyperplasia

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7
Q

What type are the disorders of the adrenal gland that are caused by secondary insufficiency?

A

pituitary/hypothalamic disorders

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8
Q

What is Addison’s caused by?

A

autoimmune destruction of adrenal cortex

Leads to reduced glucocorticoid, mineralocorticoid and sex steroids

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9
Q

What are the symptoms of Addison’s?

A 
Weight loss
grey-brown pigementation
postural hypotension
fatigue
abdominal pain
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10
Q

How is Addison’s diagnosed?

A

low Na+
high K+
low cortisol
low aldosterone

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11
Q

How is Addison’s treated?

A

hydrocortisone (cortisol replacement)

fludrocortison (aldosterone replacement)

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12
Q

What is the mechanism of Cushing’s disease?

A

Excess cortisol

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13
Q

What are symptoms of Cushing’s?

A 
easy bruising
facial plethora
striae 
Centripetal obesity 
proximal myopathy
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14
Q

List causes of Cushing’s

A

pituitary adenoma
ectopic ACTH/CRH
Adrenal adenoma
adrenal carcinoma

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15
Q

How is Cushing’s diagnosed?

A

overnight dexamethasone suppression test
24hr urinary free cortisol
late night salivary control

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16
Q

What are the 3 classes of hormones produced by the adrenals?

A

glucocorticoids
mineralocorticoids
androgens

17
Q

When is CRH released and what does it stimulate?

A

in response to circadian rhythm and it stimulates ACTH

18
Q

How does a dexamethasone suppression test work?

A

Administer synthetic glucocorticoid (dexomethasone). If normal - suppression of CRH and ACTH which leads to suppressed cortisol

19
Q

How does an ACTH stimulation test work?

A

synthetic ACTH is given which should stimulate cortisol production

20
Q

What is primary aldosteronism?

A

autonomous production of aldosterone, independent of regulators (ang II/K+)

21
Q

What are features of primary aldosteronism?

A

hypertension
hypokalaemia
alkalosis

22
Q

What are the 2 subtypes of primary aldosteronism?

A

Adrenal adenoma

Bilateral adrenal hyperplasia

23
Q

What is adrenal hyperplasia?

A

Reduced cortisol secretion leads to increased ACTH to maintain adequate cortisol. Leads to hyperplasia

24
Q

Presentation of adrenal hyperplasia?

A

sexual ambiguity

adrenal failure

25
Q

What is the most common cause of Cushing’s?

A

Adrenal adenoma

26
Q

How do you treat adrenal adenoma?

A

unilateral laparoscopic adrenalectomy

27
Q

How do you treat adrenal hyperplasia?

A

MR antagonists

28
Q

General treatment for adrenal insufficiency?

A

Cortisol and aldosterone replacement

29
Q

What is produced in the zone glomerulosa?

A

mineralocorticoids

aldosterone

30
Q

What is produced in the zone fasciulata?

A

cortisol

glucocorticoids

31
Q

What is produced in the zone reticularis?

A

sex steroids

32
Q

What type of cells secrete catecholamines?

A

neuroendocrine cells in adrenal medulla

33
Q

What are the 3 causes of adrenal hyper function?

A

hyperplasia
adenoma
carcinoma

34
Q

What is Conn’s syndrome?

A

primary aldosteronism - too much aldosterone

35
Q

What are the 2 causes of Conn’s syndrome?

A

Nodular hyperplasia

adenoma

36
Q

What are the 2 medullary tumours?

A

phaechromocytoma

neuroblastoma

37
Q

Where is a phaechromocytoma derived from?

A

chromaffin cells of adrenal medulla

38
Q

What percentage of phaechromocytomas are malignant?

A

10%

39
Q

What can cause phaechromocytoma?

A

MEN2

Endocrinology (17 decks)

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