Adrenal disorders Flashcards
What is Addison’s disease?
Adrenal failure
What is Cushing’s syndrome characterised by?
Excess cortisol
What does the left adrenal vein drain into?
Renal vein
What does the right adrenal vein drain into?
IVC
Why is it important to vaccinate people with HIB and pneumovax before elective left adrenalectomy
Left adrenalectomy can result in accidental loss of spleen
What does the zona glomerulosa produce?
Aldosterone
What does the zona fasciculata produce?
Cortisol
What does the zona reticularis produce?
Sex steroids
What does the adrenal medulla produce?
Adrenaline
Which hormones produced by the adrenal gland are steroids?
Cortisol
Aldosterone
Sex steroids
What is the precursor for all steroid hormones?
Cholesterol
How is cholesterol used to produce hormones?
Modified by enzymes
What is POMC?
A large precursor protein
Cleaved to produce ACTH, MSH and endorphins
What are the causes of Addison’s disease?
Autoimmune
Tuberculosis
What occurs as adrenal glands begin to fail?
Pituitary increases production of ACTH and MSH to support production of cortisol
But adrenal glands can’t produce cortisol
What does high levels of MSH cause?
Increased pigmentation
What are the features of Addison’s disease?
Increased pigmentation Autoimmune vitiligo may coexist No cortisol or aldosterone so low BP Low sodium High potassium
What are the biological actions of excess cortisol?
Impaired glucose tolerance
Mental changes
Hypertension
Name 8 visible features caused by excess cortisol?
Weight gain and fat redistribution Thin skin and easy bruising Striae Proximal myopathy Moon face Buffalo hump Facial hair Acne
Name 4 causes of Cushing’s syndrome
Oral steroids
Pituitary adenoma
Ectopic ACTH
Adrenal adenoma or carcinoma
What is Cushing’s disease?
Cushing’s syndrome caused by Pituitary adenoma
What are 6 clinical signs of Cushing’s syndrome
Thin skin Proximal myopathy Centripetal obesity Diabetes, hypertension and osteoporosis Immunosuppression Moon face
What causes the same features as Cushing’s syndrome?
Steroids
What would a tumour in the Zone glomerulosa cause?
Excess aldosterone production
What characterises Conn’s syndrome?
Aldosterone producing adenoma
What are the features of Conn’s syndrome?
Hypertension
Peripheral oedema as retain sodium
Low potassium
What hormone regulates the production of Cortisol?
ACTH
Where is POMC produced?
Pituitary gland
What does POMC stand for?
Pro-opio-melanocortin
What is POMC broken down into?
ACTH & MSH
How many veins do each adrenal gland have?
1
What can’t people with Cushing’s syndrome do?
Squat
due to proximal myopathy
