ADRENAL INSUFFICIENCY Flashcards
what is the מסלול of the adrenal hormones?
hypothalamus makes CRH (Corticotropin releasing hormone) which travels to the ANTERIOR PITUITARY gland. ANTERIOR PITUITARY then releases ACTH (adrenal corticotropin hormone) which travels to the Adrenal gland. The ADRENAL GLAND CORTEX then makes androgens, glucocorticosteroids (including CORTISOL) and mineral corticosteroids (aldosterone).
Actions of CORTISOL?
+ negative feedback of ACTH
+ hyperglycemia (via: stim of liver to release glucose; incrs protein catabolism; incrs insulin resistance; incrs fat deposition)
+ hypertension (via release of catacholemines)
+ decrs immune system
+ incrs osteoclasts activity (creating osteopenia)
What will happen if we are with less Cortisol?
- no negative feedback of ACTH
- hypoglycemia
- incrs ADH–> hyponatremia and hypovolemia
- decrs catecholamine release–> low BP and cardiac depression–> in extreme cases shock!
Actions of Aldosterone?
+ incrs reabsorb of Sodium and water–> incrs BP
+ release of K+ from urine
Hormones of the ADRENAL GLAND Cortex?
Aldosterone, Cortisol, Androgens
What symptoms/signs in ALDOSTERONE insufficiency?
- hyponatremia (because no reabsorb of sodium), and
- thus low BP because water won’t be reabsorbed either
- hyperkalemia (because no release of potassium in urine)
What see in in Adrenal Insufficiency?
hyponatremia hyperkalemia hypoglycemia hypovolemia shock (from hypovolemia, cariogenic, distributive)
Treatment of Adrenal Insufficiency?
+ ELECTROLYTE CORRECTION (of hyponatremia and hyperkalemia)
+ ISOTONIC BOLUSES (because of hypovolemic shock)
+ VASOACTIVE AGENTS (because of cariogenic and distributive shock)
+ REPLACEMENT OF GLUCOCORTICO STEROIDS IV CA
what else effects Aldosterone release?
if Kidneys sense low BP in afferent duct, release RENIN in response which releases ANGIOTENSIN II which increases ALDOSTERONE production