Adrenal Disorders Flashcards
Glucocorticoids
Cortisol
Involving stress management
Mineralocorticoids
Aldosterone
Fluid retention
Corticosteroid
Synthetic hormones manufactured synthetically for use as a drug.
Adrenal sex hormones
DHEA
Growth of body hair
Little effect on sexual fxn
Adrenal medulla secretes?
Epi and norepi
3 layers of adrenal cortex?
Glomerulosa: aldosterone (salt)
Fasciculata: Cortisol (sugar)
Reticularis: DHEA (sex)
Cortisol upregulates?
production of epinephrine
Chromaffin cells secrete?
Epi and norepi
Pheochromocytoma
A tumor derived form neural crest cells. Rare cause of HTN Palpitations, sweating, HA, fainting Can be surgically corrected Can tx with phenoxypheo until surgery
Where do pheochromocytomas generally occur?
The adrenal medulla
Pheochromocytoma S/S
Mirror that of epi and norepi release
Pheochromocytoma 90% rule
90% in adrenal medulla
90% unilateral
90% not malignant
90% in adults
Pheochromocytoma History Pearls
EPISODES of HTN, HA, palpitation and sweating
Catecholamines in urine DURING HTN
Hunt for source, MRI, CT
Aldosterone
Increases sodium and water reabsorption
Increases secretion of potassium
Most important sodium retaining hormone
Secretion dictated by BP, Renin-angiotensin
Primary Aldosteronism
Can be cause dby tumor Sodium conservation, potassium excretion Increased volume, HTN, hyponatermia Hypokalemia Surgical removal of tumor
Cortisol released in response so?
Stress and sleep
Cortisol does what?
Aids in metabolic fxns. Stimulates liver glucose production Promoted protein breakdown Mobilization of fatty acids Immune suppression
Adverse effects of cortisol
Hyperglycemia Immune suppression Decreased bone density CNS and mental effects Hypertension Gastric acid, pepsin production (ulcers)
Cushings Syndrome
S/S that result from prolonged exposure to excessive glucocorticoid hormones
Can be caused by a tumor, or from drug admin.
Exogenous Cushings Syndrome
Excessive steroid administration
Treating RA, SLE, COPD
Most common etiology
Adrenal adenoma causes an ACTH ________ Cushings syndrome.
independent
Endogenous Cushings Syndrome
Cushings Dz
Excessive production of ACTH
Pituitary tumor
Female to male ratio for cushings?
Females 4:1
24 hr urinary cortisol
Most direst and reliable way to measure cortisol secretion.
This is because of the fluctuation of cortisol over the course of the day
