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Endocrinology > Adrenal Glands > Flashcards

Adrenal Glands Flashcards

1
Q

What are the layers of the adrenals?

A

Capsule

Cortex

  • zona glomerulosa
  • zona fasiculata
  • zone reticularis

Medulla

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2
Q

What is produced by the zona glomerulosa?

A

Mineralocorticoids

- aldosterone

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3
Q

What is produced by the zona fasiculata?

A

Glucocorticoids

- cortisol

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4
Q

What is produced by the zone reticularis?

A

Androgens

  • testosterone
  • oestrogen
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5
Q

What cells make up the medulla?

A

Chromaffin cells

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6
Q

What is produced by the chromaffin cells?

A

Adrenaline + noradrenaline

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7
Q

What is the effect of corticosteroids?

A

Regulate gene transcription

  • bind to glucocorticoid receptors
  • causes dissociation of chaperone proteins
  • receptor ligand complex translocates to nucleus
  • receptor binds to GREs (glucocorticoid response elements)
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8
Q

What is aldosterone?

A

Mineralocorticoid

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9
Q

What is the carrier protein for aldosterone?

A

Serum albumin

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10
Q

What is the role of aldosterone?

A

Regulation of plasma Na + K

Acts of tubules and collecting duct - promote expression of Na/K pump

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11
Q

What is hyperaldosteronism?

A

Too much aldosterone produced

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12
Q

What is primary hyperaldosteronism?

A

Defect in adrenal cortex

Causes

  • bilateral idiopathic adrenal hyperplasia
  • Conn’s syndrome

Low renin levels

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13
Q

What is secondary hyperaldosteronism?

A

Overactivity of RAAS

Causes

  • renin producing tumour
  • renal artery stenosis

High renin levels

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14
Q

Signs of hyperaldosteronism

A 
High blood pressure
LV hypertrophy 
Stroke 
Hypernatraemia 
Hypokalaemia
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15
Q

Treatment of hyperaldosteronism

A

Tumours removed

Spironolactone - mineralocorticoid receptor antagonist

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16
Q

What is cortisol?

A

Glucocorticoid

17
Q

What is the carrier protein for cortisol?

A

Transcortin

18
Q

When does cortisol peak?

A

Morning at 9am

19
Q

What are the actions of cortisol?

A

Increased protein breakdown
Increased lipolysis
Increased gluconeogenesis

Anti-inflammatory effects

  • inhibits macrophage activity
  • mast cell degranulation
20
Q

What is Cushing’s syndrome?

A

Chronic excessive exposure to cortisol

21
Q

What causes Cushing’s syndrome?

A

External causes
- prescribed glucocorticoids

Endogenous causes

  • Cushing’s disease (ACTH secreting pituitary adenoma)
  • Excess cortisol produced by adrenal tumour
22
Q

Symptoms of Cushing’s disease

A 
Moon-shaped face
Neck hump 
Abdominal obesity 
Purple striae 
Hyperglycaemia 
Hypertension
23
Q

What is Addison’s disease?

A

Chronic adrenal insufficiency

24
Q

Symptoms of Addison’s disease

A 
Postural hypotension 
Lethargy 
Weight loss
Anorexia 
Increased skin pigmentation 
Hypoglycaemia
25
Q

What causes hyperpigmentation in Addison’s?

A

Decreased cortisol
Reduced negative feedback on anterior pituitary
More POMC required to synthesise ACTH
Increases MSH

MSH increases melanin synthesis

26
Q

What is an Addisonian crisis?

A

Life threatening emergency due to adrenal insufficiency

27
Q

What causes an Addisonian crisis?

A 
Severe stress
Salt deprivation
Infection 
Trauma 
Abrupt steroid drug withdrawal
28
Q

What are the symptoms of an Addisonian crisis?

A 
Nausea
Vomiting 
Pyrexia 
Hypotension 
Vascular collapse
29
Q

What is the management of an Addisonian crisis?

A

Fluid replacement

Cortisol

30
Q

What are androgens?

A

Produced in zona reticularis

Males - converted to testosterone
Females - converted to oestrogens

Promote axillary and pubic hair growth

31
Q

What is the adrenal medulla?

A

Modified sympathetic ganglion of the autonomic nervous system

32
Q

What is a phaeochromocytoma?

A

Chromaffin cell tumour - secretes catecholamines

33
Q

What are the signs of a phaeochromocytoma?

A 
Severe hypertension 
Headaches
Palpitations
Diaphoresis 
Anxiety

Endocrinology (13 decks)

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