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Endocrinology semester 1 > Adrenal glands/adrenal gland dysfunction/ exogenous steroids > Flashcards

Adrenal glands/adrenal gland dysfunction/ exogenous steroids Flashcards

1
Q

where are the adrenal glands found?

A

they are located on top of both kidneys

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2
Q

what does the adrenal gland consist of?

A

medulla (centre of the gland) and the cortex

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3
Q

what is the adrenal medulla part of?

A

The medulla is part of the Sympathetic Nervous System

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4
Q

what is the adrenal medulla responsible for?

A

it is responsible for producing epinephrine and norepinephrine

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5
Q

what is the structure of the adrenal cortex?

A

the adrenal cortex is arranged in 3 layers

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6
Q

what are the 3 layers of the adrenal cortex?

A

zona glomerulosa –> zona fasciculata –> zona reticularis

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7
Q

what does the adrenal cortex do?

A

The adrenal cortex produce small amount of both androgens (mainly dehydroepiandrosterone) and estrogens

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8
Q

function of zona glomerulosa?

A

Mainly secrete mineralocorticoid aldosterone,

hormone that help control the balance of water and electrolytes in the blood

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9
Q

function of zona fasciculata?

A

Mainly secrete glucocorticoid cortisol,
hormone that influence the energy metabolism of most body cells and help resist stressors and
affect mainly carbohydrate and protein metabolism

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10
Q

function of zona reticularis?

A

Produce small amounts of adrenal sex hormones, or gonadocorticoids which only becomes important if overproduction is present

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11
Q

what process occurs in the adrenal cortex?

A

steroidogenesis - corticosteroids are synthesised from cholesterol

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12
Q

what is the principal steroid with mineralocorticoid activity?

A

aldosterone

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13
Q

what are the principle sites of action for aldosterone?

A

distal and collecting tubule of the kidney

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14
Q

what does aldosterone do at the distal and collecting tubules of the kidney?

A

Increases resorption of sodium
Increases resorption of water
Increases renal excretion of potassium

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15
Q

what would happen to a person without aldosterone?

A

a person rapidly dies from the circulatory shock because of the fall in the plasma volume.

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16
Q

what are some of the triggers that cause aldosterone release?

A

decreased sodium or increased potassium in the blood

decreased blood volume/blood pressure

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17
Q

what are glucocorticoids?

A

affect glucose, protein and fat metabolism and other effects

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18
Q

what are the principal steroids with glucocorticoid activity?

A

cortisol or hydrocortisone

19
Q

how does cortisol increase blood glucose?

A

by
Stimulating hepatic gluconeogenesis
Decreasing glucose uptake by many tissues

20
Q

what are some of the metabolic effects of cortisol?

A

Increases protein degradation in muscles

Facilitates lipolysis in adipose tissues and causes redistribution of fats to the abdominal area and back

21
Q

what are the permissive effects of cortisol?

A

Cortisol must be present in adequate amounts to permit the catecholamines to induce vasoconstriction.

22
Q

cortisol and stress -

A

Cortisol plays a key role in the adaptation to stress

23
Q

how much cortisol may be secreted in stressful situations?

A

300 mg /day

24
Q

does cortisol have any anti-inflammatory actions?

A

Cortisol also has anti-inflammatory and immunosuppressive actions at higher concentrations. They inhibit almost all inflammatory process

25
Q

what may happen if there are excessive levels of glucocorticoids?

A

depress cartilage and bone formation,

promote changes in cardiovascular, neural, and gastrointestinal function

26
Q

how do cortisol levels change through out the day?

A

Cortisol levels are at their maximum early in the morning and then gradually taper off during the day and are at their lowest shortly after going to sleep

27
Q

what is addison’s disease?

A

occurs when the adrenal glands do not produce enough of the hormone cortisol and, in some cases, the hormone aldosterone

28
Q

what are most cases of addison’s diseases caused by?

A

the gradual destruction of the adrenal cortex are caused by autoimmune disorders

29
Q

what are some of the signs and symptoms of addison’s disease?

A

Chronic fatigue, muscle weakness, weight and appetite loss, hypotension, areas of hyperpigmentation in the skin

30
Q

what is addisonian crisis?

A

Because the symptoms progress slowly, they are usually ignored until a stressful event like an illness or an accident causes them to become worse. This is called an Addisonian crisis, or acute adrenal insufficiency.

31
Q

what are symptoms of an addisonian crisis?

A

A sudden penetrating pain in the lower back, abdomen, or leg, severe vomiting and diarrhea, dehydration, low blood pressure, loss of consciousness

32
Q

what are the treatments for addison’s disease?

A

involves replacing the hormones that the adrenal glands are not making.

33
Q

how can cortisol be replaced in the treatment of Addison’s?

A

Cortisol is replaced orally with hydrocortisone tablets.

34
Q

can aldosterone be replaced in addison’s treatment?

A

If aldosterone is also deficient, it is replaced with oral doses of a mineralocorticoid fludrocortisone.

35
Q

what is Cushing’s syndrome?

A

is a hormonal disorder of glucocorticoid excess

36
Q

what are some of the causes of Cushing’s syndrome?

A

Pituitary adenoma - Cushing’s disease
Adrenal problems such as adrenal hyperplasia, tumours of an adrenal gland
Ectopic ACTH- Such as due to some types of lung cancer.

37
Q

what is the most common cause of excess steroids in the blood?

A

long-term use of steroid medications for other disorders

38
Q

what are signs and symptoms of Cushing’s syndrome?

A

Moon face, central body obesity, thin and bruised skin, glucose intolerance, hypertension, excess hair growth, osteoporosis, kidney stones, menstrual irregularity, and emotional liability, increased susceptibility to infections.

39
Q

what does treatment of Cushing’s syndrome include?

A

Surgical removal or treatment of tumor

Drugs such as metyrapone, trilostane and aminoglutethimide which blocks synthesis of cortisol.

40
Q

what is hyperaldosteronism (Conn’s syndrome)?

A

excess aldosterone leading to hypertension and low potassium

41
Q

what is androgenital syndrome?

A

Results from excessive production of gonadocorticoids

42
Q

what does Androgenital syndrome result in?

A

Hirsutism in female
Male pseudohermaphroditism in female infants
Precocious pseudopuberty in young boys

43
Q

what is androgenital syndrome most commonly caused by?

A

an inherited enzymatic defect in the cortisol steroidogenic pathways

Endocrinology semester 1 (10 decks)

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