Adrenal conditions Flashcards
What is the name of the condition that is characterised by primary adrenal insufficiency
Addisons disease
What are the 3 types of hormones secreted from the adrenal cortex?
- mineralocorticoids
- glucocorticoids
- androgens
Give an example of a mineralocorticoid secreted from the adrenal cortex?
aldosterone
Give an example of a glucocorticoid secreted from the adrenal cortex?
Cortisol
What are the 5 physiological effects of cortisol on the body?
- Increases BP
- Immunosuppression
- Increases osteoclastic activity
- Metabolism
- Increases blood glucose levels
Describe the pathology that accounts for 70% of Addisons?
Auto antibodies that attack the adrenal cortex
What % of cases will about for autoimmune Addisons disease?
70%
True/False
Addisons disease is more common in men
FLASE
Addisons disease is more common in women
What is the name of the adrenal hormone secreted from the hypothalamus that acts on the pituitary?
Corticotrophin releasing factor
CRF
What is the name of the adrenal hormone that gets secreted from the Pituitary and acts on the adrenal cortex?
ACTH
Adrenocorticotrophic hormone
What feedback system controls hypothalamic pituitary axis?
Negative feedback
Whats is the name of the axis that controls the secretion of cortisol from the adrenal cortex?
Hypothalamic pituitary axis
What are the 3 T’s a patient with Addisons disease will present with?
Tanned
Tired
Tearful
What are the 5 symptoms that are a result from low glucocorticoids in Addisons disease?
- Generalised weakness
- tiredness
- Anorexia
- weight loss
- Pigmentations of the skin
What are the 2 symptoms that are a result from low androgens in Addisons disease?
- Less pubic and axillary hair
2. low libido
True/False
Patients with Addisons disease have primary hypertension?
False
Patients with Addisons disease have postural hypertension
What 2 blood pressure changes are visible in a patient with Addisons disease?
Lower BP
tachycardia
How might Addisons disease affect blood gluose levels?
Hypoglycaemia
Due to low levels of cortisol that is involved in increasing blood glucose levels.
What 4 GI disturbances will be seen on a patient with Addisons disease?
- Diarrhoea
2 Vomiting - Nausea
- Abdominal pain
Why is a differential diagnosis for Addisons disease?
Thyroid disorders
What are 3 blood result findings in Addisons?
- Hypokalaemia
- Hyponatremia
- Elevated urea
Why must a CT scan be carried out when suspected of Addisons disease?
To check for tumours or enlargement of the adrenal glands
Would ACTH levels be high or low in Addisons disease?
High
The presence of ? should always be checked for in Addisons disease
Auto-antibodies
What is the name of the glucocorticoid replacement therapy for Addisons disease?
Hydrocortisone
What is the name of the mineralocorticoid used for treating Addisons disease?
Fludrocortisone
What is responsible for the secretion of GH?
Anterior pituitary
What is acromegaly characterised by?
Prolonged exposure and increased secretion of GH
What aetiology accounts for 99% of acromegaly cases?
Adrenal or pituitary tumours and hyperplasia
Which type of cancers can also cause release of GH/GHRH and result in acromegaly?
Lung and pancreatic cancers
What cause the presentation of clinical features seen in acromegaly?
Prolonged and excess GH exposure that results in somatic and metabolic effects
What is hyperhidrosis seen in acromegaly?
Increased sweating
What is Bitemporal Hemianopia seen in acromegaly?
Its the loss of vision in the outer half of the eyes
What causes bitemporal hemianopia?
Compression of the optic chiasm from a significant pituitary adenoma
What complication is present in 40% of acromegaly patients?
Impaired glucose tolerance
T2DM
Name 4 cardiovascular complications that can arise as a result of acromegaly?
- Arrhythmia
- hypertension
- LV hypertrophy
- cardiomyopathy
What is the primary blood investigation for acromegaly?
IGF-1
insulin-like growth factor-1
reflect GH secretion and correlates with features of acromegaly
What is 1st line treatment for acromegaly?
Transphenodial surgery
What does Transphenodial surgery involve?
Removal of the tumours on the pituitary gland
What is another name for somatostatin?
Growth hormone inhibiting hormone
Name a somatostatin analogue that can be used as 2nd line to treat acromegaly?
Octreoide
Name a dopamine agonist that can be used to treat acromegaly?
Bromocripitine
What is 3rd line treatment in treating acromegaly?
Radiotherapy
What 3 structures secrete somatostatin?
- brain
- GI tract
- pancrease
Which hormone is more potent in inhibiting GH release?
somatostatin
dopamine
Somatostatin
