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Pathophysiology > Adrenal Gland > Flashcards

Adrenal Gland Flashcards

1
Q

adrenal glands are made up of

A

adrenal cortex
adrenal medulla
(two separate glands)

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2
Q

what does the adrenal gland respond to

A

stress

  • infection
  • heat/cold
  • dehydration
  • exercise
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3
Q

adrenal cortex secretes

A

mineralocorticoids
glucocorticoids
sex steroids

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4
Q

adrenal medulla secretes

A

epinephrine

norepinephrine

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5
Q

mineralocorticoids

A

fluid and ion balance

-promote retention of sodium and loss of potassium

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6
Q

glucocorticoids

A

play role in overall response to stress

  • preserve carbohydrates
  • mobilize amino acid
  • promote gluconeogenesis
  • anti-inflammatory
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7
Q

sex steroids secreted by adrenal cortex

A

androgens
estrogens
progestins

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8
Q

epinephrine

A

promotes glycolysis
stimulates release of ACTH
effects heart and vasculature

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9
Q

norepinephrine

A

acts upon heart and vasculature

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10
Q

pheochromocytoma

A

tumor that affects adrenal medulla

results in increased production and release of catecholamines

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11
Q

sx of pheochromocytoma

A 
excessive BP
tachycardia
headache
inappropriate sweating
GI disorders
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12
Q

hypofunction of adrenal cortex

A

“adrenal insufficiency”
decrease in hormones produced
primary (problem is in adrenal cortex) and secondary (problem is elsewhere; pituitary) types

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13
Q

hyperfunction of adrenal cortex

A

increase in hormones produced

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14
Q

primary adrenal insufficiency AKA

A

Addison’s Disease

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15
Q

incidence of Addison’s Disease

A

affects both genders equally over lifespan

rare

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16
Q

why was Addison’s Disease more common in the past

A

tuberculosis

17
Q

what typically causes Addison’s Disease

A

autoimmune disease

more than 1/2 of patients with Addison’s Disease seem to have an autoimmune disorder

18
Q

what are causes of Addison’s Disease other than autoimmune

A 
bilateral adrenalectomy
radiation to the adrenals
adrenal hemorrhage or infarct
infections (histoplasmosis or CMV)
malignancies
19
Q

what can acute adrenal insufficiency occur after?

A

surgery
pregnancy
trauma
salt loss with excessive sweating

20
Q

Addisonian crisis

A

acute adrenal insufficiency in a patient previously diagnosed with Addison’s Disease

21
Q

what is the primary cause of problems encountered by patients with Addisons

A

decreases in cortisol and aldosterone output

22
Q

what does cortisol do

A

promotes gluconeogenesis (stimulates output of blood glucose)

23
Q

what does a cortisol deficiency cause

A
  • decrease in gluconeogenesis
  • hypoglycemia
  • deficiency of liver glycogen
  • increased production of adrenocorticotropic horomone (ACTH)
  • increased release of melanocyte stimulating hormone (causes darkening of skin pigmentation)
24
Q

sx of cortisol deficiency

A 
weakness
exhaustion
hypotension
anorexia, weight loss
nausea, vomiting
mild neuroses to profound depresssion
diminished resistance to stress
25
Q

what does aldosterone do

A

causes retention of sodium and water

excretion of potassium

26
Q

sx of aldosterone deficiency

A 
hypotension
dehydration
craving for salt
elevated potassium
-most dangerous; can lead to arrhythmias
27
Q

“other” sx of Addisons

A

decreased tolerance for even minor stress
poor coordination
decreased libido
amenorrhea (due to change in sex steroids)
poor tolerance for temp change

28
Q

tx of Addison’s Disease

A

synthetic corticosteroids and mineralocorticoids

29
Q

side effects of synthetic corticosteroids and mineralocorticoids

A

more likely to develop osteoporosis, hypertension, and Type II diabetes

30
Q

why is type II diabetes a side effect of hormone replacement therapy

A

cortisol decreases insulin sensitivity

31
Q

what causes secondary adrenal insufficiency

A

hypothalamic or pituitary tumor
removal of pituitary or hypopituitarism
sudden withdrawal of corticosteroid drug therapy

32
Q

what can happen with an Addisonian crisis

A

patient can quickly go into shock and die

need immediate hospitalization

33
Q

how is secondary adrenal insufficiency different from primary

A

sx that occur are related to cortisol deficiency because the mineralocortocoids are not dependent upon pituitary control (if insufficiency is due to pituitary dysfunction)

34
Q

does hyperpigmentation occur in secondary

A

no; ACTH output is low

35
Q

tx of secondary adrenal insufficiency

A

hormone replacement therapy

Pathophysiology (19 decks)

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