ADRENAL DISORDERS

Question 1

major secretion of adrenal medulla

Answer 1

catecholamines

Question 2

most common problem in adrenal medulla

Answer 2

pheochromocytoma

Question 3

what is pheochromocytoma?

Answer 3

a tumor in the adrenal medulla

Question 4

what does pheochromocytoma releases?

Answer 4

catecholamines

Question 5

what will happen in the body if there is an increased catecholamines secretion?

Answer 5

it will enhance the SNS of the body

Question 6

manifestation of pheochromocytoma in HR

Answer 6

increased

Question 7

manifestation of pheochromocytoma in BP

Answer 7

increased

Question 8

manifestation of pheochromocytoma in sweating

Answer 8

increased

Question 9

why is there malignant HTN in pheochromocytoma if the tumor is usually benign?

Answer 9

hypertension will not be resolved unless you took the tumor out

Question 10

outer portion of the adrenal gland

Answer 10

adrenal cortex

Question 11

inner portion of the adrenal gland

Answer 11

adrenal medulla

Question 12

3 layers in the adrenal cortex

Answer 12

zona glomerulosa, zona fasciculata, zona reticularis

Question 13

what does the zona glomerulosa secretes?

Answer 13

mineralocorticoids

Question 14

what does the zona fasciculata secretes?

Answer 14

glucocorticoids

Question 15

what does the zona reticularis secretes?

Answer 15

sex hormones

Question 16

what mineralocorticoids does the zona glomerulosa secretes?

Answer 16

aldosterone

Question 17

what glucocorticoids does the zona fasciculata secretes?

Answer 17

cortisol, prednisone

Question 18

what sex hormones does the zona reticularis secretes?

Answer 18

androgen and estrogen

Question 19

major secretion of sex hormones of zona reticularis

Answer 19

androgens

Question 20

what is androgen responsible for?

Answer 20

secondary male characteristics

Question 21

underproduction of androgens will cause

Answer 21

muscle wasting

androgens inc. muscle mass

Question 22

overproduction of androgens in women will cause

Answer 22

virilization
hirsutism

Question 23

development of male secondary characteristics in women

Answer 23

virilization

Question 24

what is aldosterone responsible for?

Answer 24

inc. H2O and Na reabsorption in kidneys

Question 25

overproduction of aldosterone will cause

Answer 25

hypertension, hypernatremia, hypervolemia

Question 26

underproduction of aldostereone will cause

Answer 26

hypotension, hyponatremia, hypovolemia

Question 27

function of cortisol in the body

Answer 27

inc. blood sugar anti-stress anti-inflammatory effect H2O retention mobilization of fats inc. HCl acid protein and fat metabolism vasoconstriction inc. osteoclast activity

Question 28

overproduction of cortisol will cause

Answer 28

water retention inc. HCl acid hypertension hyperglycemia osteoporosis truncal obesity, moon face, buffalo hump immunocompromised weight gain purple striae

Question 29

underproduction of cortisol will cause

Answer 29

hypoglycemia dec. HCl acid dec. water retention hypotension weight loss

Question 30

what feedback mechanism will be activated if there is increased ACTH?

Answer 30

negative feedback mechanism

Question 31

what feedback mechanism will be activated if there is decreased ACTH?

Answer 31

positive feedback mechanism

Question 32

how does negative feedback mechanism works?`

Answer 32

if hormones is increased, it will send signal to pituitary gland to decrease the ACTH to decrease the androgen, aldosterone, cortisol back to normal

Question 33

how does positive feedback mechanism works?

Answer 33

if hormones is decreased, it will send signal to pituitary gland to increase the ACTH to increase the androgen, aldosterone, cortisol back to normal

Question 34

why do we need to check the ACTH level and the androgen, aldosterone, cortisol level?

Answer 34

to know where is the problem

Question 35

if the aldosterone, cortisol, androgen is increased and the ACTH is decreased, where is the problem?

Answer 35

adrenal cortex - negative feedback mechanism is working so pituitary gland is okay but adrenal cortex is not functioning properly

Question 36

if the aldosterone, cortisol, androgen is increased and the ACTH is also increased, where is the problem?

Answer 36

pituitary gland - no feedback mechanism

Question 37

if the aldosterone, cortisol, androgen is decreased and the ACTH is increased, where is the problem?

Answer 37

adrenal cortex - pituitary gland functions well because feedback mechanism is intact

Question 38

if the aldosterone, cortisol, androgen is decreased and the ACTH is also decreased, where is the problem?

Answer 38

pituitary gland - no feedback mechanism

Question 39

a condition where there is overproduction of adrenal cortex hormones

Answer 39

cushing's disease

Question 40

most common cause of cushing's disease

Answer 40

adrenal gland tumor

Question 41

if the cause of cushing's is the overused of steroids, what is it?

Answer 41

cushing's syndrome - there is only increased cortisol

Question 42

why do we need inc. potassium rich food in the diet of patients with cushing's disease?

Answer 42

because there is inc. potassium excretion

Question 43

what surgery is needed if there is a hyperplasia of the adrenal gland?

Answer 43

bilateral adrenalectomy

Question 44

what surgery is needed if there is a tumor on one side of the adrenal gland?

Answer 44

adrenalectomy

Question 45

drug therapy for cushing's disease

Answer 45

glutethimide mithotane

Question 46

if there is an overuse of steroids, what consideration must we do to correct the overconsumption?

Answer 46

gradual withdrawal of steroids

Question 47

why do we need to gradually decrease the steroids use?

Answer 47

to prevent adrenal insufficiency

Question 48

another reason on why do we need to gradually decrease the steroids use?

Answer 48

increased cortisol in the body will cause the adrenal gland to atrophy - > decreased production of hormones

Question 49

a condition where there is an underproduction of adrenal cortex hormones

Answer 49

addison's disease

Question 50

what skin color is manifesting in patients with addison's disease?

Answer 50

bronze skin color

Question 51

hypovolemic shock in addison's disease is called

Answer 51

addisonian crisis

Question 52

why does patients with addison's have bronze skin color?

Answer 52

due to inc. melanocyte activity that secretes too much melanin

Question 53

where do you see first the hyperpigmentation in patient's with addison's?

Answer 53

gums, oral cavity

Question 54

priority management for addison's disease

Answer 54

maintain fluid balance

Question 55

drug replacement for aldosterone

Answer 55

fludrocortisone

Question 56

drug replacement for androgen

Answer 56

testosterone

Question 57

when do we replace androgen in patients with addison's disease?

Answer 57

if there is severe muscle wasting

Question 58

drug replacement for cortisol

Answer 58

prednisone, dexamethasone, hydrocortisone

Question 59

how to replace cortisol?

Answer 59

2/3 in morning 1/3 in evening

Question 60

what should we follow in replacing cortisol?

Answer 60

diurnal pattern of steroids release

Question 61

why is cortisol higher in the morning?

Answer 61

because it is an anti-stress hormone that is released during start of day where we can start feeling stressed