Adrenal Gland Flashcards

1
Q

5 layers of the adrenal glands

A

Capsule
Zona glomerulosa
Zona fasciculata
Zona reticularis
Medulla

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2
Q

Which arterial plexus is in the zona glomerulosa

A

Sub capsular plexus

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3
Q

Which arterial plexus is in the zona reticularis and medulla

A

Medullary plexus

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4
Q

Which hormones activate the mineralocorticoid receptor

A

Cortisol
Aldosterone

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5
Q

What conditions cause primary hyperaldosternism

A

Conn’s syndrome
Aldosterone producing adenoma
Bilateral adrenal hyperplasia

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6
Q

What is the effect of aldosterone binding to mineralocorticoid receptors in the distal convoluted tubule

A

Incr sodium reabsorption
Incr potassium extretion

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7
Q

What does 11betaHSD-2 do

A

Converts cortisol to cortisone

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8
Q

Characteristics of Liddle syndrome

A

Hypertension
Hypokalemia
Metabolic alkalosis

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9
Q

What does ACTH binding to melanocortin-2 receptors cause

A

Up regulation of steroidogenesis

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10
Q

Glucocorticoid remediable aldosteronism

A

rare form of hyperaldosteronism‐induced arterial hypertension. autosomal dominant trait in which ACTH increases the activity of existing aldosterone synthase, resulting in an abnormally high rate of aldosterone synthesis and hyperaldosteronism

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11
Q

When are ACTH and cortisol levels highest

A

Just before waking

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12
Q

When are ACTH and cortisol levels lowest

A

Night

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13
Q

How do glucocorticoids effect starvation, infection, and hypotension

A

Cause tissue breakdown for fuel
Cause immunosuppressive
Increase BP

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14
Q

Why does Cushing syndrome cause thin skin and osteoporosis

A

Muscles, bones, and skin broken down to get subtpstrates for Gluconeogenesis

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15
Q

What condition is caused by too much cortisol

A

Cushings syndrome

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16
Q

What condition is caused by too little cortisol

A

Addisons disease

17
Q

What causes Addison’s disease

A

Primary renal failure

18
Q

What are the 4 characteristics of an addisonian crisis

A

Low BP
Low glucose
Low Na
High K

19
Q

Cushing’s syndrome treatment

A

Surgery on pituitary
Radiotherapy on pituitary
Adrenalectomy
Metyrapone/ketoconazole/etomidate

20
Q

Cushing’s syndrome symptoms

A

Dorsal fat pad
Thin skin
Easy bruising
Muscle weakness
Osteoporosis
Obesity
Stretch marks
Enlarged heart
High BP
Round face
Ulcers

21
Q

Addison’s disease symptoms

A

Fatigue
Weakness
Myalgia
Anorexia
Weight loss
Hyperpigmentation

22
Q

Addison disease management

A

Replacement steroid -
Hydrocortisone for glucocorticoid
Fludrocortisone for mineralocorticoid

23
Q

Addisonian crisis management

A

IV fluid resuscitation
IM hydrocortisone

24
Q

What is the most abundant steroid in circulation

A

DHEA Dehydroepiandrosterone

25
Adrenarche
Maturation of the zona reticularis at age 8-10
26
How does adrenarche trigger puberty
Triggers GnRH pulse generator
27
Adrenal androgens
DHEA androstenedione
28
What does congenital adrenal hyperplasia cause
Salt loss Adrenal insufficiency Virilisation Adrenal hyperplasia
29
What amino acid are catehpcholamines synthesised from
L-tyrosine
30
Where are chromaffin cells found
Adrenal medulla Para aortic sympathetic chain Organ of zuckerkandl Wall of urinary bladder Neck and mediastinal sympathetic chain
31
Types of adrenoreceptor
Alpha 1 and 2 Beta 1 2 and 3 D 1 and 2
32
Symptoms of catecholamine excess
Impending doom Diaohoresis Dyspnea Headache Hypertension Palpitation Tremor Nausea Vomiting Fatigue Orthostatic HT Hyperglycaemia Weight loss Epigastric and chest pain Congestive heart failure
33
What cells does phaeochromocytoma arise in
Adrenal medulla chromaffin cells
34
What cells does paraganglioma arise in
Extra adrenal chromaffin cells
35
What is PPGL
Phaeochromocytoma and paraganglioma Both chromaffin cell tumours
36
PPGL signs and symptoms
Hyperadrenergic spells Resistant HT Familial yndrome Adrenal mass Press or response during general anaesthesia Early onset HT Dilated cardiomyopathy
37
PPGL diagnosis
24 hr urine metanephrines Plasma metanephrines CT/MRI adrenals and abdomen 1-MIBG scintigraphy
38
PPGL treatment
Surgical resection Pre operative alpha and beta blockade - phenoxybenzamine + propranolol I-MIBG therapy Acute crisis - phentolamine or nicardipine
39
PPGL acute crisis treatment
IV phentolamine or nicardipine