Adrenal Pathway Dysfunction Flashcards
adrenal cortex makes?
corticosteroids
mineralcorticoids, glucocorticoids, sex steroids
steroid hormones are derived from
cholesterol
actions of aldosterone include?
increases blood pressure
retains sodium
reduce potassium
effect of ACTH on adrenals?
stimulates cortisol production
cholesterol to aldosterone
cholesterol > pregnenolone > progesterone > deoxycorticosterone > aldosterone
cholesterol to cortisol
cholesterol > pregnenolone (17-OH) > progesterone (17-OH) > cortisol
cholesterol to oestrogen
cholesterol > pregnenolone > progesterone > androstenedione > testosterone > estradiol
cortisol has what type of rhythm?
diurnal
what is Addison’s disease?
primary adrenal failure
two causes of addison’s
autoimmunity
TB
Symptoms of addison’s
increased pigmentation vitiligo low blood pressure fatigue weight loss hyperkalaemia
consequences of adrenocortical failure
abdominal pains, vomiting, muscle weakness and fatigue, depression, low blood pressure, weight loss, kidney failure, changes in mood and personality, and shock (adrenal crisis)
POMC is a precursor to
MSH
ACTH
tests for addison’s
9am cortisol
blood test ACTH
+ve result low cortisol high ACTH
short synACTHen test measure cortisol response
Replacement aldosterone is? why is it administered?
fludrocortisone
longer half life
makes it a once daily tablet
Replacement cortisol is? Why?
prednisolone
mimics diurnal rhythm
Commonest congenital adrenal hyperplasia caused by?
complete or partial 21 hydroxylase deficiency
if a patient is deficient in 21 hydroxylase, what hormones are absent?
aldosterone and cortisol
age of presentation of complete 21 hydroxylase deficiency
as a neonate salt losing addisonian crisis
girls may have ambiguous genitalia
before birth foetus gets steroids from
across placenta
with partial 21 hydroxylase deficiency what is the age of presentation?
any age as they survive
main symptoms of partial 21 hydroxylase deficiency
hirsutism
virilisation in girls
precocious puberty in boys (adrenal testosterone)
11 deoxycorticosone behaves like?
aldosterone
11 deoxycorticosone in excess can cause?
hypertension
hypokalaemia
with 11 hydroxylase deficiency which hormones are deficient and which in excess?
deficient: cortisol aldosterone
excess: sex steroids testosterone 11 deoxycorticosone
with 17 hydroxylase deficiency, which hormones are deficient and which in excess?
deficient: cortisol, sex steroids
excess: aldosterone , 1 deoxycorticosone
