Adrenal Gland Flashcards

1
Q

What is the adrenal cortex under control of?

A

The anterior pituitary

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2
Q

Which groups of hormones are secreted from the adrenal cortex?

A

Glucocorticoids (cortisol)
Androgens (testosterone)
Mineralocorticoids (aldosterone)

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3
Q

What hormones does the adrenal medulla secrete?

A

Epinephrine and norepinephrine

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4
Q

What are the most common causes of hypersecretion of the adrenal cortex?

A

Cortical tumor or hyperplasia of adrenal cortex -> excessive cortisol and decrease ACTH
Ectopic ACTH secretory tumor
Tumor or hyperplasia in the anterior pituitary leading to excess ACTH

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5
Q

What does the secretion of cortisol inhibit?

A

ACTH secretion from anterior pituitary

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6
Q

True or false: groups of cells in anterior pituitary are responsible for secreting ONE hormone

A

True

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7
Q

What is the most common cortical hypersecretion disease?

A

Cushings

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8
Q

What hormone is being hyper secreted in cushing’s?

A

Cortisol

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9
Q

What are the actions of cortisol?

A
Steroid
Anti inflammatory 
Increase protein breakdown
Increase mobilization of fatty acids 
Stimulates gluconeogenesis
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10
Q

What occurs in Cushing’s syndrome?

A

Protein catabolism -> weak muscles
Lipid deposition in face & shoulders (Buffalo hump)
Gluconeogenesis which is not metabolized and hyperglycaemia occurs

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11
Q

What occurs with prolonged hyperglycaemia?

A

Insulin resistance

Impaired glucose tolerance

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12
Q

What is an odd result to occur in Cushing’s syndrome?

A

HTN and hypokalemia as persistently increase cortisol has a mineralocorticoid feature (aldosterone which secretes potassium at the level of the kidneys & sodium and water retention)

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13
Q

What happens to the immune response of someone with cushing’s?

A

The immune response will be suppressed and individual will be more susceptible to infections

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14
Q

What is something that SOMETIMES occurs in Cushing’s and is more of a concern for females rather than males?

A

Androgen hypersecretion leading to excess testosterone. If it occurs in females they gain secondary sex characteristics of males

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15
Q

What is the treatment for Cushing’s?

A

Excise tumor if it is a tumor
Irradiate pituitary
Drugs for ectopic tumor (to suppress hormone release)
Adrenalectomy

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16
Q

What is hypersecreted in conn syndrome?

A

Mineralocorticoid (aldosterone)

17
Q

Is conn syndrome common?

A

Not at all

18
Q

What causes conn syndrome?

A

Cortical adenine
Idiopathic cortical hyperplasia
Renin secreting time in kidney (RAAS activated -> excessive aldosterone)

19
Q

What are the manifestations of conn syndrome?

A

HTN due to excessive aldosterone

Hypokalemia and alkalosis because aldosterone excretes potassium and hydrogen ions

20
Q

What is the treatment for conn syndrome?

A

Adrenalectomy for adenoma (unilateral usually)
Drugs for hyperplasia (aldosterone receptor antagonist)
Sodium restriction

21
Q

In most endocrine disorders involving the adrenal glands, which part of the adrenal gland is most commonly affected?

22
Q

What is Addison’s disease?

A

Primary deficiency of the adrenal cortex

23
Q

In Addison’s disease, which groups of hormones are affected?

A

All 3 types (glucocorticoids, mineralocorticoids, and androgens)

24
Q

Is Addison’s disease common?

25
What is the etiology of Addison's disease?
Autoimmunity Tumor Infection High dose glucocorticoid treatment leading to decreased ACTH secretion
26
Is the adrenal gland destructed in Addison's disease?
Yes
27
What are manifestations of Addison's disease?
Hypotension, weakness and fatigue (from excess fluid loss) - from less aldosterone Weight loss because hyperglycaemia would set in and glucose lost in urine - from less glucocorticoid Decrease GAS from less cortisol
28
What is an addisonian crisis?
Rapid decrease in cortisol levels | Has acute onset
29
What is the acute treatment for Addison's disease?
IV fluids | IV glucocorticoids and deal with stress
30
What is the chronic treatment for Addison's disease?
Glucocorticoids and mineralocorticoids