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Endocrinology > Adrenal pathology > Flashcards

Adrenal pathology Flashcards

1
Q

What are the 3 layers of the cortex?

A
  • zona glomerulosa
  • zona fasciculata
  • zona reticularis
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2
Q

What does the medulla release

A
  • catecholamines

- adrenaline and noradrenaline

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3
Q

What does the zona glomerulosa release?

A
  • aldosterone
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4
Q

What does the zona fasciculata release?

A
  • cortisol
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5
Q

What does the zona reticularis release?

A
  • adrenal androgens
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6
Q

What is cortisol and androgens release dependant on?

A
  • control from hypothalamus and pituitary
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7
Q

What controls the aldosterone release?

A
  • RAAS
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8
Q

What type of receptors do corticosteroids act on?

A
  • nuclear receptors
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9
Q

What is the effects of cortisol

A
  • increase cardiac output
  • increases blood pressure
  • immunosuppressant
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10
Q

What are steroids used for in medicine?

A
  • suppress inflammation
  • suppress immune system
  • replacement treatment
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11
Q

Name a mineralocorticoid?

A
  • aldosterone
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12
Q

What is the effect of aldosterone?

A
  • sodium reabsorption
  • k+ excretion
  • blood pressure regulation
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13
Q

Name a cause of primary adrenal insufficiency

A
  • addison’s disease
  • congenital adrenal hyperplasia
  • adrenal TB
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14
Q

Secondary causes of adrenal insufficiency

A
  • lack of ACTH stimulation
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15
Q

symptoms of Addison’s disease?

A
  • Anorexia
  • fatigue
  • weight loss
  • skin pigmentation
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16
Q

What is the effect of ACTH on skin?

A
  • increased ACTH causes darker skin pigmentation
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17
Q

Addison’s disease is autoimmune destruction of what?

A
  • adrenal cortex
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18
Q

Investigations for Addison’s disease?

A
  • low sodium
  • high potassium
  • short synacthen test
  • adrenal autoantibodies
19
Q

What is the short synacthen test?

A
  • synthetic ACTH
  • measure cortisol release
  • in Addison’s less cortisol
20
Q

Treatment of Addison’s

A
  • hydrocortisone
  • fluids
  • fludrocortisone
21
Q

What should a patient with Addison’s carry?

A
  • emergency steroid card

- in Addison’s crisis - IV steroids

22
Q

What is the skin difference in Addison’s vs secondary adrenal insufficiency?

A
  • Addison’s high ACTH = skin pigmentation

- secondary causes low ACTH = no skin pigmentation

23
Q

What is Cushing’s syndrome?

A
  • excess cortisol secretion

- not by pituitary causes

24
Q

What is Addison’s disease?

A
  • too little cortisol
25
What is the appearance of someone with Cushing's syndrome?
- moon face - striae - proximal myopathy
26
Diagnosing Cushing syndrome?
- overnight dexamethasone suppression test | - cortisol remains high
27
Complication of long term steroid usage?
- suppresses ACTH production | - when ill requires more steroid
28
Effect of aldosterone?
- increases blood pressure - increases sodium retention - risk of atheroma
29
Conn's syndrome?
- excess aldosterone - secondary hypertension due to low potassium levels - tumour in cortex?
30
Diagnosis of Conn's syndrome?
- Aldosterone:renin ration raised | - saline suppression test
31
Treatment of Conn's syndrome?
- surgical - unilateral laparoscopic adrenalectomy | - spironolactone
32
CAH stands for?
- congenital adrenal hyperplasia
33
What deficiency is associated with CAH?
- 21a hydroxylase deficiency
34
What is the hormone levels in CAH?
- Too little corticosteroids | - more sex hormones
35
What genetic influence is CAH?
- Autosomal recessive
36
Symptoms of CAH?
- poor weight gain - salt wasting - simple virlising
37
Treatment of CAH?
- Glucocorticoid replacement
38
What stimulates adrenaline and noradrenalin?
- dopamine | - tyrosine stimulates dopamine
39
What are symptoms of phaeochromocytoma?
- labile hypertension - postural hypotension - sweating, headaches, tachycardia
40
What is phaeochromocytoma associated with?
- MEN2
41
Differential diagnosis for phaeochromocytoma?
- angina - anxiety - arrhythmia - menopause
42
What can be used for diagnosis of phaeochromocytoma?
- catecholamines in urine - elevated plasma metanephrine - MIBG scan
43
Treatment of phaeochromocytoma?
- alpha blockers - surgery - beta blockers - genetic testing
44
Diagnosing CAH?
- 17 OH progesterone increased | - genetic testing

Endocrinology (16 decks)

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