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Summer 2020 - Physiology 2 - Endocrine > Adrenal Glands - Quiz 3 > Flashcards

Adrenal Glands - Quiz 3 Flashcards

1
Q

What are the 3 areas in the Adrenal Gland’s cortex?

A

True Endocrine Gland

Zona Glomerulosa - Outer Most - Mineralcorticoids: Aldosterone (90%)

Zona Fasciculata - Middle - Glucocorticoids: Cortisol

Zona Reticularis - Middle - Androgens: Dehydroepiandrosterone (DHEAS) or Testosterone

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2
Q

Where are the Adrenal Glands located?

A

Atop Kidneys (SupraRenal)

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3
Q

What do the Adrenal Glands do?

A

Triangular / Semilunar gland that releases stress hormones

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4
Q

The Adrenal Gland has both a _____, meaning “outer layer”, and a ______, meaning “inner region”

A

The Adrenal Gland has both a Cortex, meaning “outer layer”, and a Medulla, meaning “inner region”

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5
Q

What is secreted from the Medulla of the Adrenal Glands?

A

Modified Sympathethic Ganglion

Catecholamines: 80% Epinephrine & 20% Norepinephrine

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6
Q

List 1 - 5

A
  1. Capsule
  2. Zona Glomerulosa
  3. Zona Fasciculata
  4. Zona Reticularis
  5. Medulla
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7
Q

What are all steroids synthesized from?

A

Cholesterol

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8
Q

What are the minerals/electrolytes that Mineralcorticoids control?

A

Sodium & Potassium

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9
Q

What does Aldosterone do?

A

Long term regulation of Blood Pressure by effecting salt & water balance

Sodium & Water Retention & Excretes Potassium & Hydrogen

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10
Q

What stimulates the release of Aldosterone?

A

Hemorrhage

Upright Posture

Low Sodium

Increased Potassium

ACTH

Serotonin

Acetylcholine

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11
Q

What inhibits the release of Aldosterone?

A

Dopamine

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12
Q

Which part of the kidney does Aldosterone mainly effect?

A

Distal Convoluted Tubules & Collecting Ducts

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13
Q

What are the 4 main Aldosterone Controllers?

A

Potassium

Angiotensin II

Sodium

ACTH - minor effect

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14
Q

How does the Renin-Angiotensin System (RAS) work?

A

Hypovolemia / Reduced Renal Blood Flow –> Kidneys release Renin –> Converts Angiotensinogen to Angiotensin I –.> ACE converts to Angiotensin II –> stimulates Aldosterone secretion

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15
Q

What is Conn’s Syndrome?

A

Primary Hyperaldosteronism d/t Aldosterone secreting tumors or hyperplasias

Renin will be low

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16
Q

What causes Secondary Hyperaldosteronism?

A

CHF

Cirrhosis w/ Ascites

Nephrosis

ECF lost to Extravascular Space

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17
Q

What happens in Adrenal Insufficiency?

A

Sodium Lost in Urine & Potassium Retention

↓Plasma Volume

Hypotension

Hyperkalemia

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18
Q

How does the body react to Short-Term Stress?

A

Hypothalmus –> Nerve Impulses –> Spinal Cord –> Preganglionic Sympathetic Fibers –> Adrenal Medulla –> Catecholamines

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19
Q

How does the body react to Prolonged Stress?

A

Hypothalamus –> Corticotropin releasing hormone –> Anterior Pituitary –> ATCH via Blood stream -> Adrenal Cortex –> Mineralocorticoids & Glucocorticoids

Slower reaction

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20
Q

Which type of feedback controls the release of Glucocoritcoids?

A

Negative Feedback

High cortisol levels signal Hypothalamus stop releasing ACTH & CRH

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21
Q

What do Glucocorticoids do?

A

Makes protein into Carbs

Mobilizes Amino Acids from muscles, weakening them

Elevates Blood Glucose

Decreases Glucose Utilization

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22
Q

How does Cortisol prevent and resolve inflammation?

A

Stabilizes Lysomes

↓Capillary Permeability

↓WBC Migration

Enhances Healing

23
Q

What causes Cushing’s Syndrome?

A

Cortisol Excess

ACTH secreting Tumors

Overactive CRH secretion

Adrenal Tumor

Chronic Administration

24
Q

Whats the difference b/t Cushing’s Syndrome & Cushing’s Disease?

A

Cushing’s Disease is primarily from ACTH secreting tumor of the Pituary Gland

25
What are some connective tissue problems associated w/ Cushing's Syndrome?
Thin Skin Easy Bruising Poor Healing Collagen Formation Stretch Marks
26
What bone problems does Cushing's Syndrome cause?
Calcium Absorption Inhibition Osteoporosis Easy Fractures
27
How does Cushing's Syndrome affect Muscle & Body Fat?
Wasting & Weakness Central/Truncal Obesity Moon Face Buffalo Hump
28
What are the CV effects of Cushing's Syndrome?
HTN & DVT/PE
29
Hirsutism, Acne, Impaired glucose tolerance, and Amenorrhea are all symptoms of what?
Cushing's Syndrome
30
What are the CNS effects of Cushing's Syndrome?
Euphoria Irritability Depression Emotional Instability
31
What causes Addison's Disease?
Failure to produce Adrenocortical Hormones Primary: Autoimmune Adrenal _Non-Function_ Secondary: Hypothalmic / Pituitary _Dysfunction_
32
What are Symptoms of Addison's Disease?
Hypoglycemia Fatigue Weight Loss Anorexia Hyperpigmentation Stress Intolerance
33
What can lead to Hypothalmic / Pituitary _Dysfunction_?
Chronic Glucocorticoid Therapy & Pituitary Tumor Removal
34
What is an Addisonian Crisis?
Cardiovascular Collapse Treat w/ Cortisol
35
How does Addison's Disease affect Fluids & Electrolytes?
Dehydration Polyuria Hypotension Low Sodium Potassium Retention Metabolic Acidosis
36
What happens if Addison's Disease goes untreated?
Death w/in 4 days to 2 wks Treat w/ Glucocorticoids and mineralocorticoids
37
How should patients w/ Addison's disease be managed PeriOperatively?
They cant increase cortisol level in response to stress = Hypotension & CV Collapse Give Large dose of Glucocorticoids
38
List the potency of steroids from greatest to least Of these, which have Mineralocorticoid Properties?
Dexamethasone \> Fludrocortisone \> Methylprednisolon \> Prednisone, Prednisolone \> Hydrocortisone Mineralocorticoid Properties: Fludro \> Hydrocortisone \> Prednisone & Prednisolone
39
Which type of surgeries would you give higher doses of steroids PeriOperatively?
100-150mg Hydrocoritisone CV, Thoracic, and Liver Surgeries
40
Which type of surgeries would warrant 25 mg of Hydrocortisone for Adrenal Supplementation?
Inguinal Hernia & Colonoscopy
41
Which surgeries call for a moderate dose of Adrenal Supplementation Perioperatively?
50-75mg Hydrocortisone Colon Resection Total Abdominal Hysterectomy Total Joint
42
How can Etomidate affect Cortisol?
Profound Supression x 24 hrs & Hypotension
43
How is the Adrena Medulla connected to the Nervous System?
Directly Connected - fast response - and bridges endocrine & sympathetic system
44
How does the Adrenal Medulla make Catecholamines?
via Chromaffin cells
45
What is the synthesis pathway for Epinephrine?
Tyrosine --\> Dopa --\> Dopamine --\> Norepinephrine --\> **Phenylethanolamine N- Methyltransferase** --\> Epinephrine
46
What influences the expression of Phenylethanolamine N-Methyltransferase (PNMT)?
Glucocorticoids
47
What is Pheochromocytoma?
**Tumor that makes catecholamines in an unregulated fashion** HTN Tachycardia Sweating Headache Anxiety & Tremor Glucose Intolerance
48
Where are Pheochromocytomas normally found?
Right Adrenal Gland
49
What is the pathway in which Adrenaline breaks down?
Adrenaline --\> Catechol-O-Methyltransferase (COMT) --\> Metanephrine --\> Monamine Oxidase (MOA) --\> Vanillylmandelic Acid (VMA)
50
What should be given before surgery to patients who have Pheochromocytoma?
Alpha Blockers 10 - 14 days b4 surgery Phenoxybenzamine - Nonselective alpha blocker Prazosin - Alpha 1 blocker
51
In regards to Pheochromocytoma & Blood Pressure, in which order should receptors be blocked?
Block Alpha first, then Beta to avoid extremes in BP
52
If theres no time to pretreat with Phenoxybenzmine or Prazosin, what else can be given?
Nitroprusside Calcium Channel Blockers - Cardene Labetalol Atenolol Propranolol
53
During an Adrenalectomy, what drugs should be avoided?
Histamine releasing drugs - reglan, glucagon, morphine
54
What are problems associated w/ Medullary Hyposecretion?
None - SNS & Other hormones will compensate

Summer 2020 - Physiology 2 - Endocrine (5 decks)

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