adrenal cortex pt 1 Flashcards
What hormones are secreted by the adrenal glands?
Glucocorticoids, mineralocorticoids, and androgens.
What do adrenal gland hormones affect?
Glucose availability, water/electrolyte balance, sex characteristics, stress responses.
What are the functions of glucocorticoids?
Maintain glucose levels, protein metabolism, fat metabolism, cardiovascular support, CNS effects, stress response, neonatal respiratory function.
How do glucocorticoids affect carbohydrate metabolism?
Stimulate gluconeogenesis, reduce peripheral glucose use, inhibit glucose uptake by muscle & fat, promote glycogen storage.
What is the role of glucocorticoids in stress?
Help increase blood glucose to meet energy demands.
What do mineralocorticoids regulate?
Renal processing of sodium, potassium, and hydrogen.
What is the function of aldosterone?
Conserves sodium & water, promotes potassium excretion, regulates plasma volume.
What system regulates aldosterone?
The renin-angiotensin-aldosterone system (RAAS).
What happens when aldosterone is at high levels?
Harmful cardiovascular effects.
What is Cushing’s syndrome?
A condition of adrenal hormone excess.
What causes Cushing’s syndrome?
ACTH hypersecretion (pituitary adenomas), adrenal adenomas/carcinomas, or long-term high-dose glucocorticoid use.
What are the symptoms of Cushing’s syndrome?
Hyperglycemia, glycosuria, hypertension, fluid/electrolyte disturbances, osteoporosis, muscle weakness, myopathy, hirsutism, menstrual irregularities, immunosuppression, weak skin, fat redistribution, psychiatric effects.
How is Cushing’s syndrome treated?
Adrenalectomy for carcinoma/adenoma, glucocorticoid & mineralocorticoid replacement for bilateral adrenalectomy, ketoconazole as an adjunct.
What is primary hyperaldosteronism?
Excessive aldosterone secretion due to adrenal adenoma or bilateral adrenal hyperplasia.
What are the effects of primary hyperaldosteronism?
Hypokalemia, metabolic alkalosis, hypertension.
How is primary hyperaldosteronism treated?
Surgery or aldosterone antagonists like spironolactone.
What is Addison’s disease?
Primary adrenocortical insufficiency due to autoimmune destruction (80%) or infections like TB (15%).
What are the symptoms of Addison’s disease?
N/V/D, anorexia, weakness, weight loss, abdominal pain, hyperkalemia, hyponatremia, hypotension, increased skin/mucous membrane pigmentation.
What is the treatment for Addison’s disease?
Adrenocorticoid replacement therapy (hydrocortisone is DOC); patients should keep extra doses on hand.
What is acute adrenal insufficiency (adrenal crisis)?
A life-threatening condition due to adrenal or pituitary failure or abrupt corticosteroid withdrawal.
What are the symptoms of adrenal crisis?
Hypotension, dehydration, weakness, lethargy, vomiting, diarrhea, shock, death if untreated.
How is adrenal crisis treated?
Rapid fluid/salt/glucocorticoid/glucose replacement, hydrocortisone bolus, NS with dextrose, continuous hydrocortisone infusion (100mg/8hr).
What is congenital adrenal hyperplasia?
A genetic disorder causing excessive androgen production.
What are the effects of congenital adrenal hyperplasia?
Girls – masculinized genitalia; Boys – precocious penile enlargement; Children – increased growth; Adults – shorter height.
How is congenital adrenal hyperplasia treated?
Glucocorticoids (hydrocortisone, dexamethasone, prednisone).
What is secondary adrenocortical insufficiency?
Decreased secretion of ACTH, leading to reduced glucocorticoid secretion.
What is tertiary adrenocortical insufficiency?
Decreased secretion of CRH, leading to reduced glucocorticoid secretion.
How are secondary and tertiary adrenocortical insufficiencies treated?
Glucocorticoid replacement therapy (hydrocortisone).
