adrenal gland cis

Question 1

What is pheochromocytoma

Answer 1

tumor of chromaffin tissue

Question 2

What are the symptoms like in pheochromocytoma

Answer 2

hypertension, orthostatic hypotension
headaches, sweating, palpitations
anxiety, chest pain, flushing

Question 3

What does pheochromocytoma produce

Answer 3

excess catecholamines

Question 4

what degrades epineprhine, dihydroxymandelic acid and norepi

Answer 4

catechomaline-O-methyltransferase

Question 5

What are measure to determine total catecholamine production

Answer 5

catecholamines, metanephrines, vanillylmandelic acid

Question 6

Where is vanillylmandelic acid found

Answer 6

in the urine

Question 7

What type of receptor is a catecholamine R

Answer 7

adrenergic

Question 8

What catecholamine has a higher affinity for the Beta 2 R

Answer 8

epinephrine

Question 9

Which Receptor is responsible for a pounding heart and increased HR

Answer 9

Beta 1, norepi and epi

Question 10

What Receptor is responsible for increased BP and cold hands and feet

Answer 10

alpha 1

Question 11

What type of drug would you give someone to control their BP prior to surgery

Answer 11

an alpha 1 adrenergic antagonist

Question 12

What hormone is in excess in cushing’s

Answer 12

cortisol

Question 13

what hormone is deficient in hypocotisolism

Answer 13

cortisol and aldosterone

Question 14

When sex steroids are in excess what is it called

Answer 14

hirsutism/virilization

Question 15

What are the various causes of cushings

Answer 15

ACTH dependent, independent, factitious

Question 16

What are the Dx tests for cushings

Answer 16

overnight DST, or late night salivary cortisol or 24 hr urine free cortisol

Question 17

What is the DST lab

Answer 17

dexamethasone suppression test

Question 18

explain the abnormal central adiposity in cushings with wasting of legs

Answer 18

excess cortisol affects metabolism

also causes proteolysis (wasting of legs)

Question 19

Why do you see decreased bone density in cushings

Answer 19

cortisol inhibits bone formation, increased bone resorption

Question 20

how does cushings lead to hypertension

Answer 20

cortisol upregulates alpha adrenergic R on vascular smooth muscle
cross reactivity with mineralocotricoid R (increase aldosterone?)

Question 21

how does cushings lead to hyperglycemia

Answer 21

increased gluconeogenesis

Question 22

What are cortisol’s effects on immune system

Answer 22

anti-inflammatory and suppress immune responses

Question 23

what would be the effects of no cortisol on BP

Answer 23

hypotension

Question 24

What are the effects of cortisol on LH, FSH, TSH, GH

Answer 24

decreases the release

Question 25

what is 11B-HSdehydrogenase 2 responsible for

Answer 25

the cross-reactivity of cortisol with mineralocorticoid R

Question 26

What happens in oversaturation of the 11B-HSD2 enzyme

Answer 26

overproduction of aldosterone, leading to hypokalemia

Question 27

What are causes of primary adrenal insufficiency(addisons)

Answer 27

``` autoimmune(autoAb) metastatic disease adrenalectomy infectious adrenalitis adrenoleukodystrophy hemorrhagic infarction infiltrative drugs congenital adrenal hyperplasia ```

Question 28

What can cause infectious adrenalitis

Answer 28

TB disseminated fungal infections HIV

Question 29

lack of cortisol response to ACTH stimulation test indicates deficiency in what

Answer 29

adrenal gland

Question 30

What are aldosterone levels like in someone with pituitary loss

Answer 30

normal because of renin

Question 31

how are primary and secondary adrenal insufficiency different

Answer 31

primary presents with hyperpigementation

Question 32

which R binds ACTH

Answer 32

MC2R

Question 33

at high levels ACTH, what other R does it cross react with? result?

Answer 33

cross with MC1R which causes an increase in pigmentation

Question 34

What are the types of primary hyperaldosteronism

Answer 34

bilateral hyperplasia of zona glomerulosa solitary aldosterone-producing adenoma adrenal carcinoma glucocorticoid-remediable aldosteronism

Question 35

What are key signs to primary aldosteronism

Answer 35

hypertension, hypokalemia, hypomagnesemia | metabolic alkalosis

Question 36

What is an appropriate screening test for recognizing feedback loops in adrenal disease

Answer 36

ratio of aldosterone to plasma renin activity

Question 37

how can Na levels be normal range in hyperaldosteronism

Answer 37

Na escape method

Question 38

if urinary cortisol is high DST does not suppress ACTH levels are high What is the classification of cushings

Answer 38

ACTH dependent

Question 39

What test do you do to evaluate endocrine function if you suspect cortisol deficiency

Answer 39

stimulation. ACTH

Question 40

why do patients with secondary adrenal insufficiency have hyponatremia

Answer 40

increased ADH secretion, dilutes