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Clin Lab > Adrenal Glands > Flashcards

Adrenal Glands Flashcards

1
Q

What is the purpose of the adrenal glands?

A

Produce hormones that enable patients to cope with changing environments

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2
Q

Where are the adrenal glands located?

A

A pair of small glands that rest on the superior pole of each kidney

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3
Q

What is the collective name for the hormones that they adrenal glands produce?

A

Corticosteroids

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4
Q

What are corticoids that effect sodium and potassium

A

Mineralocorticoids

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5
Q

What are corticoids that regulate carbohydrate metabolism?

A

Glucocorticoids

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6
Q

These are sex hormone precursors?

A

Gonadocorticoids

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7
Q

This hormone is produced by the anterior pituitary and regulates glucocorticoid and gonadocorticoid synthesis

A

ACTH (adrenocorticotroptic hormone)

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8
Q

What controls ACTH?

A

CRH (corticotropic releasing hormone) from the hypothalamus

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9
Q

What regulates the minerocorticoid pathway

A

Angiotensin 2

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10
Q

What is secreted by nephrons in response to blood pressure and to sodium levels in the nephron’s tubules.

A

Renin

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11
Q

What is the plasma substrate from which renin produces angiotensin I.

A

Angiotensinogen

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12
Q

What converts angiotensin 1 into angiotensin 2?

A

Pulmonary converting enzyme

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13
Q

What stimulates aldosterone secretion and sodium and water retention

A

The conversion of angiotensin 1 to angiotensin 2

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14
Q

This disease is the result of excess glucocorticoids

A

Cushings Syndrome/Disease

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15
Q

What causes high levels of glucocorticoids?

A
  • Prolonged ACTH stimulation
  • Glucocorticoid therapy for other treatments
  • Adrenal Tumors
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16
Q

What is primary disease?

A

Effects the organ itself

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17
Q

What is secondary disease?

A

Involves an organ or cause elsewhere

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18
Q

This is a way to describe any condition that produces an elevation in glucocorticoid levels.

A

Cushings syndrome

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19
Q

This is when the disorder is caused by a pituitary lesion. It is named after the neurosurgeon who first published the description of the disease

A

Cushings disease

20
Q

Characteristics of Cushing’s Disease

A
  • Moon face
  • Muscle weakness
  • Hypertension
  • Fat deposition in abdomen and base of neck
21
Q

What can cause the production of accessive ACTH?

A

Pituitary tumor

22
Q

What are causes of secondary cushing syndrome?

A
  • Hypothalamus tumor
  • Non-endocrine tumor
  • Brochogenic carcinoma
23
Q

This is hypersecretion of the aldosterone secreting cells of the adrenal cortex

A

Primary Hyperaldosteronism

24
Q

What is another name for primary hyperaldosteronism?

A

Conn’s syndrome

25
Q

What can cause Conns Syndrome/ Primary Hyperaldosteronism

A

-Cortical adenoma

26
Q

What can Conns syndrome result in?

A

-Systemic hypertension due to sodium and water retention of the kidney

27
Q

What is the basic idea behind secondary hyperaldosteronism?

A

-Aldosterone is released in response to activation of the RAA system

28
Q

What are examples of things that cause secondary hyperaldosteronism?

A
  • CHF
  • Pregnancy
  • Decreased renal perfusion
  • Hypoalbuminemia
29
Q

What are causes of adrenocortical hyposecretion?

A
  • Destruction of the adrenal cortex
  • Suppression of ACTH by high therapeutic doses of glucocorticoids
  • Infection
  • Tumor
  • Adrenal infarction
30
Q

What is the most common cause of Adrenocortical hyposecretion?

A

Addisons disease

31
Q

Autoimmune disease in which destruction of the adrenal gland occurs causing inability to secrete adequate amounts of corticosteroids.

A

Addisons disease- Primary Adrenocortical insufficiency

32
Q

What are symptoms of Addisons disease- Primary Adrenocortical insufficiency

A
  • Weakness
  • Fatigue
  • Anorexia
  • Hyperpigmentation of skin
33
Q

Any disorder of the hypothalamus and pituitary such as metastatic cancer, infection, infarction or irradiation that reduces the output of ACTH.

A

Secondary adrenocortical insufficiency

34
Q

What are symptoms of Secondary adrenocortical insufficiency

A
  • Weakness
  • Fatigue
  • Anorexia
  • NO Hyperpigmentation of skin
35
Q

These 2 levels can be measured but are difficult to interpret sometimes due to the effects of stress and sleep cycle variations

A
  • Cortisol

- ACTH

36
Q

T/F- tests that evaluate cortisol and ACTH response to physiologic factors may be more reliable.

A

True

37
Q

Almost all cortisol is bound to…?

A

Cortisol binding globulin

38
Q

When is plasma cortisol the highest? Lowest?

A
  • 8 am is highest

- 11 am is lowest

39
Q

This measures the degree to which plasma cortisol exceeds protein binding capacity

A

Urine free cortisol

40
Q

What are precursors of cortisol that can be measured when trying to establish a diagnosis of congenital adrenal hyperplasia?

A
  • 17-Hydroxysteriods

- 17-Ketosteroids

41
Q

This is the major androgen produced by the adrenal gland and can be measured in the plasma or the urine

A

DHEA-S

42
Q

During this test… patient is given a dose of dexamethasone (synthetic steroid) which should suppress ACTH production and therefore decrease cortisol.

A

Dexamethasone Suppression Test

43
Q

This test… uses synthetic bioactive ACTH to test adrenal cortisol producing ability

A

Cortrosyn Stimulation Test

44
Q

Laboratory Findings with Cushings disease (ACTH, urine free cortisol, d-suppression test)

A
  • Elevated ACTH levels
  • Elevated Urine Free Cortisol levels
  • Dexamethasone Suppression Test reveals failure to suppress cortisol levels
45
Q

Laboratory Findings with Cushing’s Syndrome (urine free cortisol, ACTH)

A
  • Elevated Urine Free Cortisol levels

- ACTH will typically be elevated but will be depressed if adrenal tumor secreting increased cortisol.

46
Q

Laboratory findings with adrenal insufficiency

A
  • Addison’s disease will show an elevated ACTH and low plasma and urine cortisol levels.
  • Cortrosyn Stimulation test will reveal no increase in cortisol levels.
  • Secondary cases of insufficiency will show a depressed ACTH and cortisol level.

Clin Lab (23 decks)

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