Adrenal Disorders Flashcards

1
Q

Describe the arrangement of the adrenal veins.

A

The right adrenal vein drains directly into the IVC

The left adrenal vein drains to the left renal vein and then to the IVC

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2
Q

Describe the passage of blood through the adrenal gland.

A

The blood flows through the adrenal arteries and arterioles in the cortex where it picks up all the adrenal hormones and then it drains into a single CENTRAL VEIN.

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3
Q

What are the three layers of the adrenal gland from the outside to the inside?

A
Zona Glomerulosa (aldosterone)
Zona Fasciculata (cortisol)
Zona Reticularis (doesn't do much - evolutionary remnant)
Adrenal Medulla (catecholamines)
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4
Q

What is the precursor for ACTH?

A

Proopiomelanocortin – POMC

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5
Q

Why does an increase in ACTH cause hyperpigementation of the skin?

A

POMC is broken down to ACTH and Melanocyte Stimulating Hormone (MCH) which stimulates the pigmentation of the skin.

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6
Q

What is Addison’s Disease?

A

Primary adrenal failure

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7
Q

What can Addison’s Disease be caused by? State the most common cause in the UK and the most common cause worldwide.

A

UK - autoimmune disease - the immune system wipes out the adrenal cortex
Worldwide - tuberculosis

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8
Q

State some clinical features of Addison’s Disease.

A
Pigmentation of the skin
Weight loss 
Hypotension 
Muscular weakness
Autoimmune vitiligo
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9
Q

What are the steps that need to be taken if a patient is experiencing an Addisonian Crisis?

A

Rehydrate with saline
Dextrose tablets to counteract the hypoglycaemia due to lack of cortisol
Hydrocortisone or another glucocorticoid medication

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10
Q

What are the consequences of excess cortisol?

A

Impaired glucose tolerance (due to chronic elevation of blood glucose)
Interscapular fat pad
Moon face
Hypertension
Striae (stretch marks- they suddenly got fat really quickly)
Thin skin and easy bruising due to
Proximal myopathy (proximal=thigh muscles)- they can’t climb stairs)

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11
Q

State four causes of Cushing’s Syndrome.

A

Oral steroid drugs
Pituitary tumour causing overproduction of ACTH
Ectopic ACTH (some lung cancer cells can produce ACTH)
Adrenal adenoma or carcinoma releasing cortisol

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12
Q

What is the difference between Cushing’s Syndrome and Cushing’s Disease?

A

Cushing’s Syndrome is a constellation of symptoms

Cushing’s Disease = when the cause of Cushing’s Syndrome is known as being a pituitary adenoma

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13
Q

What is Conn’s Syndrome?

A

Aldosterone producing adenoma

Leads to hypertension, oedema and hypokalaemia

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