Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endo Week 1 > Adrenal Disorders > Flashcards

Adrenal Disorders Flashcards

1
Q

does acute or chronic stimulation of adrenal lead to hypetrophy?

A

chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the precursor for all the hormones of the adrenal cortex?

A

pregnenolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when is peak cortisol level?

A

usually 8am or right after patient wakes up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

`what is not made in primary adrenal insufficiency?

A

no cortisol or aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the most common cause of primary adrenal insufficiency?

A

autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the most common cause of primary adrenal insufficiency in developing countries?

A

infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what three bugs are common for primary adrenal insufficiency?

A

TB, HIV, histoplasmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what infiltrative diseases can cause primary adrenal insufficiency?

A

tumors, amyloid, sarcoid, hemachromacytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what heme issue can cause primary adrenal insufficiency?

A

spontaneous with disseminated intravascular coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what drugs can cause primary adrenal insufficiency?

A

ketoconazole and rifampin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does elevated ACTH breakdown lead to?

A

increased MSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what can MSH cause in someone?

A

hyperpigmentation esp at skin folds and palms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what pituitary hormone is elevated in primary adrenal insufficiency?

A

ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

where does secondary adrenal insufficiency occur?

A

pituitary or hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what features arise in primary adrenal insufficiency from low cortisol?

A 
faitgue/weight loss
hypotension
abdominal pain
hyponatremia
hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is most common non iatrogenic cause of secondary adrenal insufficiency?

A

pituitary or hypothalamic tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is most common cause of secondary adrenal insufficiency?

A

iatrogenic from surgery or exogenou steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

explain how glucocorticoid use can lead to secondary adrenal insufficiency?

A

prolonged glucos decreases ACTH and you get adrenal cortical atrophy…so then if you take them off quickly from the glucos they do not re make the adrenal quickly enough and get deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what hormones are lost insecondary adrenal insufficiency?

A

only glucocorticoids..adosterone is still good

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

in secondary adrenal insufficiency what is hyponatremia from?

A

los of glucocorticoids

21
Q

in primary adrenal insufficiency what is hyponatremi from?

A

both aldo and gluco loss

22
Q

in secondary AI, when will you have falsely normal cortisol response to ACTH?

A

acute pituitary failure because the adrenal has not had time to atrophy

23
Q

what is Rx for primary adrenal insufficiency loss of glucos?

A

hydrocortisone and prednisone

24
Q

what activities does hydrocortisone have?

A

mineralocorticoid and gluococorticoid

25
Q

what is Rx for primary adrenal insufficiency loss of aldos?

A

fludrocortisone or hydrocortisone

26
Q

what do you have to do with cortisol rx for patients in stress? do you do this with aldos in stress?

A

need to double or triple the dose….do not do with aldos

27
Q

what is rx for secondary AI?

A

glucocorticoid replacement…not mineralocorticoid…so prednisone and dexamethasone possible

28
Q

what is the name for autoimmune primary adrenal insufficiency?

A

addisons disease

29
Q

what is seen with skin in primary adrenal insufficiency?

A

ACTH increases and you get more melanin so hyperpigmentation

30
Q

name the five features of primary AI from low cortisol

A 
fatigue/weight loss
hypotension
abdominal pain
hyponatremia
hypoglycemia
31
Q

what are features of low androgen in primary AI?

A

loss of pubic and axillary hair

32
Q

what i the number one iatrogenic cause of secondary AI?

A

long term use of gluococoticoids

33
Q

what is the cosynotropin stimulation test?

A

give ACTH and see if cortisol levels rise in the plasma

34
Q

does secondary or primary AI respond better to the cosynotropin test?

A

secondary has higher rise in the cortisol

35
Q

why do patients with secondary AI, despite making some cortisol, fail to produce normal amount in cosynotropin test?

A

adrenal has atrophied

36
Q

what is inheritance of congenital adrenal hyperplasia?

A

AR

37
Q

what is issue in congenital adrenal hyperplasia?

A

mutation in enzyme of adrenal steroid synthesis pathwya

38
Q

what is most common enzyme deficiency in congenital adrenal hyperplasia?

A

21-hydroxylase

39
Q

what is the first step in production of steroids in adrenal? what stimulates this?

A

cholesterol to pregnenolone

this is stimulated by ACTH

40
Q

pregnenolone then becomes what in aldosterone formation?

A

progesterone

41
Q

progesterone can lead to what two things in the steroid production in adrenal?

A

11-deoxycortisone and 17-OH progesterone

42
Q

17-OH progesterone and progesterone are turned down the cortisol and aldosterone pathway respectively, but by what enzyme?

A

21-OHase

43
Q

so in congenital adrenal hyperplasia when 21-OHase does not work, what cannot be made? what is there excess of?

A

cortisol and aldo cant be produced and androgens are overproduced

44
Q

if you have severe cortisol deficiency in 21-OHase what happens?

A

vascular collapse, vomiting death

45
Q

androgen excess in 21-OHase deficiency leads to what?

A

masculinization of external genitalia in female infants and hirsutism

46
Q

what enzyme is in charge of turning 11-deoxycorticosterone and 11-deoxycortisol into aldo and cortisol respictively?

A

11-hydroxylase

47
Q

what builds up in 11-hydroxylase deficiency?

A

11-dexoycortisone and androgens

48
Q

what is role of 11-deoxycortisone?

A

can actually act as a weak mineralocorticoid…so it leads to hypertension

Endo Week 1 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions