Adrenal Gland

Question 1

What are the three zones of the cortext of the medulla?

Answer 1

Zona Glomerulosa

Zona Fasciculata

Zona reticularis

Question 2

What is synthsised in the zona glomerulosa?

Answer 2

Aldosterone

Question 3

What is synthsised in the zona fasiculata?

Answer 3

Cortisol

Question 4

What is synthesised in the zona reticularis?

Answer 4

Androstenedione

Question 5

What are the three hormones produced in the adrenal glands?

Answer 5

Aldosterone

Cortisol

Androgen

Question 6

What regulates the three hormones?

Answer 6

Cortisol and androgen by hypothalmus and anterior pituitary gland

Aldosterone regulated by renin-angiotensin system

Question 7

What are the causes of primary adrenal insufficiency?

Answer 7

Addison’s disease

Congenital adrenal hyperplasia

Adrenal TB

Malignancy

Question 8

What is addison’s disease?

Answer 8

Autoimmune destruction of adrenal cortex

Question 9

What are the clincial features of addison’s disease?

Answer 9

Anorexia and weight loss

fatigue

dizziness and low BP

Abdominal pain, vomiting and diarrhoea

Skin pigmentation

Question 10

What woud you find in the renin and aldosterone levels in somone with addisons disease?

Answer 10

renin would be increased

Aldosterone would be decreased

Question 11

How do you treat adrenal insufficiency?

Answer 11

give hydrocortisone as a cortisol replacement

Question 12

What must you advice patients about when they are diagnosed with adrenal insufficiency?

Answer 12

take more hydrocortisone if they are sick

dont stop their medication suddenly

wear identification

Question 13

What are possible causes of secondary adrenal insufficiency?

Answer 13

Pituitary or hypothalmic tumours

exogenous steroid use

Question 14

What does CRH stand for and what does it do?

Answer 14

Corticotropin releasing hormone produced by the hypothalmus stimulates the anterior pituitary to produce adrenocorticotrophic hormone ACTH

Question 15

What hormones could be lacing in secondary adrenal insufficiency?

Answer 15

Corticotrophin releasing hormone CRH

or

adrenocorticotrophic hormone ACTH

Question 16

What clinical features differentiate primary and secondary adrenal insuffiiciency?

Answer 16

In secondary adrenal insufficiency:

Skin is pale

Aldosterone production is intact as it is governed by the renin-angiotensin system

Question 17

How do you treat secondary adrenal insufficiency ?

Answer 17

hydrocortisone replacement

Question 18

What is primary aldosternism?

Answer 18

Autonomous production of aldosterone independent of its regulators

Question 19

What clincial finding might suggest primary aldosteronism?

Answer 19

Hypertension with hypokalaemia

Question 20

What is conn’ syndrome ?

Answer 20

Adrenal adenoma ( primary aldosteronisim)

Question 21

What is congenital adrenal hyperplasia?

Answer 21

Rare conditions associated with enzyme defects in the steroid pathway

Question 22

How does Congenital Adrenal hyperplasia present in males and females?

Answer 22

Males

Adrenal insufficiency and poor weight gain

Females

Genital ambiguity

Question 23

How do you treat congeintal adrenal hyperplasia?

Answer 23

Mineralcorticoid replacement

glucoroticoid replacement

achieve maximal growth

Question 24

What is a phaeochromocytoma?

Answer 24

Adrenal medullary tumour

Question 25

What is the classical traid in phaechromocytoma?

Answer 25

Hypertension

headache

sweating