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Endocrinology > Adrenal Disorders > Flashcards

Adrenal Disorders Flashcards

1
Q

Glucocorticoids

A

Cortisol

Involving stress management

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2
Q

Mineralocorticoids

A

Aldosterone

Fluid retention

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3
Q

Corticosteroid

A

Synthetic hormones manufactured synthetically for use as a drug.

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4
Q

Adrenal sex hormones

A

DHEA
Growth of body hair
Little effect on sexual fxn

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5
Q

Adrenal medulla secretes?

A

Epi and norepi

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6
Q

3 layers of adrenal cortex?

A

Glomerulosa: aldosterone (salt)
Fasciculata: Cortisol (sugar)
Reticularis: DHEA (sex)

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7
Q

Cortisol upregulates?

A

production of epinephrine

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8
Q

Chromaffin cells secrete?

A

Epi and norepi

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9
Q

Pheochromocytoma

A 
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
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10
Q

Where do pheochromocytomas generally occur?

A

The adrenal medulla

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11
Q

Pheochromocytoma S/S

A

Mirror that of epi and norepi release

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12
Q

Pheochromocytoma 90% rule

A

90% in adrenal medulla
90% unilateral
90% not malignant
90% in adults

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13
Q

Pheochromocytoma History Pearls

A

EPISODES of HTN, HA, palpitation and sweating
Catecholamines in urine DURING HTN
Hunt for source, MRI, CT

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14
Q

Aldosterone

A

Increases sodium and water reabsorption
Increases secretion of potassium
Most important sodium retaining hormone
Secretion dictated by BP, Renin-angiotensin

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15
Q

Primary Aldosteronism

A 
Can be cause dby tumor
Sodium conservation, potassium excretion
Increased volume, HTN, hyponatermia
Hypokalemia
Surgical removal of tumor
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16
Q

Cortisol released in response so?

A

Stress and sleep

17
Q

Cortisol does what?

A 
Aids in metabolic fxns.
Stimulates liver glucose production
Promoted protein breakdown
Mobilization of fatty acids
Immune suppression
18
Q

Adverse effects of cortisol

A 
Hyperglycemia
Immune suppression
Decreased bone density
CNS and mental effects
Hypertension
Gastric acid, pepsin production (ulcers)
19
Q

Cushings Syndrome

A

S/S that result from prolonged exposure to excessive glucocorticoid hormones
Can be caused by a tumor, or from drug admin.

20
Q

Exogenous Cushings Syndrome

A

Excessive steroid administration
Treating RA, SLE, COPD
Most common etiology

21
Q

Adrenal adenoma causes an ACTH ________ Cushings syndrome.

A

independent

22
Q

Endogenous Cushings Syndrome

A

Cushings Dz
Excessive production of ACTH
Pituitary tumor

23
Q

Female to male ratio for cushings?

A

Females 4:1

24
Q

24 hr urinary cortisol

A

Most direst and reliable way to measure cortisol secretion.

This is because of the fluctuation of cortisol over the course of the day

25
Q

Primary adrenal insifficiency

A

Addison’s dz
Dysfxn or destruction of adrenal cortex
Autoimmune destruction

26
Q

Secondary renal insufficiency

A

Results from inadequate stimulation of adrenal cortex by ACTH
Usually occurs as a result of DC’ing steroids

27
Q

Addison’s Disease

A

Both glucocorticoid and mineralocorticoids are destroyed in this disease.
Can be fatal if untreated
Adrenal medulla fxn is spared

28
Q

Adrenal insufficiency presentation

A 
Hypotension
Weight loss, fatigue
Vomiting, diarrhea, anorexia
Myalgias, Abd pain
Postural dizziness
29
Q

Pathognomonics of Addison’s Dz

A 
Hyperpigmentation (from increased melanocyte stimulation hormone)
Salt craving (hyponatremia)
30
Q

ACTH Test

A

Cosyntropin Test
Measure cortisol
Administer 250ug ACTH
Measure cortisol again

31
Q

If increased ACTH?

A

Primary adrenal insufficiency

32
Q

Decreased ACTH?

A

Secondary adrenal insufficiancy

Pituitary

33
Q

Addison’s Tx

A

Lifelong replacement of Glucocorticoids and mineralocorticoids

34
Q

Addison’s Crisis (Acute adrenal insufficiency)

A

IV cortisone

Prompt recognition

35
Q

Fludrocortisone

A

Both glucocorticoid and mineralocorticoid activity.
Used for adrenal insufficiency
Not used as antiinflamitory

36
Q

Corticosteroid strength comparison

A 
Strongest
Dexamethasone
Methylprednisolone
Prednisone
Hydrocortisone

Endocrinology (16 decks)

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