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hlsc 222- midterm 2 > Adrenal Cortex > Flashcards

Adrenal Cortex Flashcards

1
Q

Glucocortiocoids

A

increase availability of glucose

Cortisol: most important product

Physiological effects occur at low levels

Pharmacological effects occurs at high levels

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2
Q

Cushing Disease

A

when a physiological effect results in high levels of cortisol

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3
Q

Glucocorticoids Physiological effects

A

opposite of insulin

promote glucose availability

maintain integrety of vasucylar system
reduced GC = vasucalr permeability increases = BP falls

increase RBC counts

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4
Q

Stress response

A

GC= increased cortisol (blood glucose)

Adrenal Meducal = increased secretion of epinephrine (increased BP)

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5
Q

regulation of GC

A

neg. feedback system

secretion: 2 activations
1) Bassal stimulation to maintain a basal level that follows circadian rhythm

2) stress: increased cortisol at times of stress

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6
Q

Aldosterone
renal physiological effects

A

promote sodium and potassium hemostasis

maintains BV/BP

promtes sodium reabsorption in exchange for potassium secretion

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7
Q

Aldosterone regulation

A

via RAAS

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8
Q

Cushing Syndrome

A

excessive circulatory glucocorticoids

cause: hyper secretion of ACTH by
(1) pituitary adenomas
(2) adrenal adenomas

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9
Q

Cushing Syndrome treatment

A

partial or full surgical removal of diseased adrenal glad

replacement with glucocorticoids/ mineralocorticoids as needed

Mitotane: anticancer drug that destroys adrenal cortex tissue

drugs adjucts to surgery and radiation

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10
Q

Adenoma

A

tumor that is not cancer

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11
Q

Osilodrostat for cushings

A

when surgery is not appropriate/ successful

po/ inhibits final step cortisol synthesis in adrenal gland

adverse effect: prolong QT
- hypokalemia, hypermagnesemia

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12
Q

Primary Hyperaldosteronism

A

effect of increased renal reabsorption of sodium and water
= incrased BV/BP

Result: Hyptertension hyper kalemia, heart failure

Cause: adrenal adenoma or bilateral adreal hyperplasia

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13
Q

Treatment for Primary Hyperaldosternosim

A

adrenal adenoma = surgery

bilateral adrenal hyperplasia = aldosterone antagonist

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14
Q

Adrenocortical Hormone Insufficiency

A

Cause: malfunction along hormonal pathway, including destruction of adrenal gland

treatment lifelong replacement therapy
glucocorticoids/ mineralocorticoids or both

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15
Q

Glucocorticoid drugs
what should they do

A

Hydrocortisone, prednisone, dexamethasone

mimic circadian rhythm of glucocorticoids

mineral corticoids can be administered 1x/day

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16
Q

primary Adrenocortical Hormone Insufficiency Diseases

A

Addisons disease

autoimmune destruction of adrenal glands

adrenal atrophy
= reduced glucocorticoids/mineralocorticoids

17
Q

primary adrenocortical insufficient treatment

A

replacement therapy with hydrocortisones
(has both glucocorticoids and mineralocorticoids)

administration: IM or IV

18
Q

secondary and tertiary adrenocortical insufficiency

A

secondary: decreased secretion of ACTH

tertiary: decreased secretion of CRH

adverse effects: glucocorticoids diminished/ no effect on mineral corticoids

treatment: replacement therapy with Hydrocortisone

19
Q

acute adrenal insufficiency (Adrenal Crisis)

A

Cause: pituitary/ adrenal failure/ failure to provide replacement patients adequate dose of glucocorticoids

Symptoms:
hypotension, dehydration, vomiting, diarrhea/ can progress to shock/death

20
Q

treatment of acute adrenal insufficiency (adrenal crisis)

A

Step1: rapid replacement of fluids, salt, and glucocorticoids

Step 2: inject 100 mg hydrocortisone (IV bolus), followed by IV infusion of normal saline with dextrose/ additional hydrocortisone given at a rate of 50 mg every 8 hours

21
Q

Gongenital Adrenal Hyperplasia

A

Cause: inborn deficiency of enzymes needed for glucocorticoid synthesis (doesnt effect mineralocorticoids)

note: to attempt to compensate, pituitary releases large amounts of ACTH

22
Q

Treatment of congenital adrenal hyperplasia

A

1) ensure adequate levels of glucocorticoids

2) prevent excess production of ACTH

  • Hydrocortisone= (1) supplies glucocorticoids which then (2) suppresses ACTH production
23
Q

Hydrocortisone

A

synthetic steroid identical to cortisol

PO: chronic replacement therapy

Parenteral: acute and to supplement oral doses at times of stress

nonendocrine disorders: allergic reactions to cancer

adverse effects:
low doses: no adverse effects
large doses = highly toxic

24
Q

Fludrocortisone

A

treatment for hypoaldosteronism

adverse effects
doses too large = magnified effect of mineralocorticoids
result: increased BV/BP, hypokalemia

preparations
available in 0.1mg tablets
normal dose: 1 tablet/ day

hlsc 222- midterm 2 (9 decks)

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