Adrenal Review

Question 1

What are the suprarenal gland?

Answer 1

Adrenal glands

Question 2

In general what hormones are the adrenal glands responsible for releasing?

Answer 2

Stress hormones

Question 3

T/F: The cortex of the suprarenal gland is the inner region.

Answer 3

FASLE (The CORTEX of the adrenal gland is the outer layer.)

Question 4

T/F: The adrenal glands are connected directly to the parasympathetic nervous system via the nerves.

Answer 4

FALSE: (The adrenal glands are connected directly to the SYMPATHETIC nervous system via the nerves.)

Question 5

The adrenal medulla ________ the endocrine and sympathetic nervous system.

Answer 5

bridges

Question 6

What cells make catecholamines in the adreanl medulla?

Answer 6

Chromaffin cells

Question 7

What are catecholamines derived from?

Answer 7

tyrosine

Question 8

T/F: DOPA, Dopamine, Norepinephrine, and epinephrine are the FOUR catecholamines in the suprarenal glands.

Answer 8

TRUE

Question 9

T/F: Epinephrine is made ONLY in the adrenal medulla.

Answer 9

TRUE

Question 10

How much epinephrine is made in the adrenal medulla gland?

Answer 10

80%

Question 11

How much norepinephrine is made in the adrenal medulla gland?

Answer 11

20%

Question 12

T/F: A scant amount of dopamine is made in the adrenal medulla.

Answer 12

TRUE

Question 13

Between Epinephrine and Norepineprine which one has a stronger beta-1 effect?

Answer 13

Epinephrine

Question 14

What two type of tumors cause pheochromocytoma?

Answer 14

• Adrenal hyperplasia

- extra-adrenal chromaffine tissue

Question 15

What are the symptoms of pheochromocytoma?

Answer 15

• paroxysmal hypertension
• tachycardia
• headache
• sweating
• anxienty
• tremor
• glucose intolerance

Question 16

Of the pheochromocytoma tumors __% are extra-medullary, of these __% are in the abdomen.

Answer 16

• 10%

- 95%

Question 17

Over _____% of Pheochromocytoma tumors are ___________ tumors localized to a single adrenal gland (mostly in the ______)

Answer 17

• 85-90%
• solitary
• right

Question 18

What lab level would strongly indicate pheochromocytoma.

Answer 18

-Urinary Vanillylmandelic Acid

Question 19

What does norepinephrine and epinephrine degrade down to?

Answer 19

-Urinary vanillylmandelic Acid

Question 20

Treating a patient with Pheochromocytoma before surgery with Alpha adrenergic antagonist does?

Answer 20

Reduces incidence of:

• B/P fluctuations
• MI
• CHF
• dysrhythmias
• CVA

Question 21

(Pheochromocytoma) What medications are used for blocking alpha 1 receptors?

Answer 21

• phenoxybenzamine

- prazosin

Question 22

(Pheochromocytoma)How many days needed to pretreat a patient with alpha 1 blockers?

Answer 22

10-14 days

Question 23

What should the anesthesia provider be aware of when the pheochromocytoma tumor is removed?

Answer 23

-Abrupt hypotension

First line of treatment is fluids and the second line in vasopreassors

Question 24

How long until catecholmine levels return to normal after pheochromocytoma tumor is removed?

Answer 24

-Three days the catecholamine levels will return to normal (Approximately 75% of patient will be normotensive in 10 days

Question 25

What is the function of the adrenal cortex?

Answer 25

-Mediates the stress response

Question 26

Production of what substances from the adrenal cortex help mediate the stress response?

Answer 26

- mineralocorticoids | - glucocorticoids

Question 27

T/F: The adrenal cortex also produces androgen synthesis.

Answer 27

TRUE

Question 28

The three layers of the adrenal cortex are:

Answer 28

- Zona glomerulosa (outer) - zona fasciculata (middle) - Zona reticularis (Inner)

Question 29

What does the zona glomerulosa produce?

Answer 29

mineralocorticoids

Question 30

What does the zona fasciculata produce?

Answer 30

glucocorticoids

Question 31

What does the zona reticularis produce?

Answer 31

Androgens

Question 32

The mineralocorticoids is responsible for ________.

Answer 32

Aldosterone

Question 33

The glucocorticoid is responsible for ________.

Answer 33

Cortisol

Question 34

The Androgen is responsible for _______.

Answer 34

Androstenedione

Question 35

What electrolytes are controlled by the mineralocorticoids?

Answer 35

- Na+ | - K+

Question 36

What part of the kidney is affected by aldosterone?

Answer 36

- Distal convoluted tubule | - Collecting ducts

Question 37

What primarily regulates aldosterone?

Answer 37

- Renin-angiotensin system | - Potassium levels

Question 38

What causes primary hyperaldosteronism.

Answer 38

TUMOR

Question 39

What causes secondary hyperaldosteronism?

Answer 39

- CHF - cirrhosis with ascites - Nephrosis

Question 40

What happens if there is adrenal insufficiency?

Answer 40

- Na lost in the urine - (K+) retained - circulatory collapse

Question 41

T/F: Cortisol is also called ______________.

Answer 41

Hydrocortisone

Question 42

Adrenocorticotropic hormone (ACTH) stimulates ________secretion.

Answer 42

cortisol

Question 43

T/F: Corticotropin releasing factor (CRH) releases ACTH.

Answer 43

TRUE

Question 44

Where is corticotropin released from?

Answer 44

-hypothalmus

Question 45

What is CUSHING disease?

Answer 45

-ACTH secreting tumor of the pituitary

Question 46

What is Addison Disease?

Answer 46

-Failure to produce adrenocortical hormones

Question 47

What is PRIMARY Addison disease?

Answer 47

-adrenal nonfunction mostly autoimmune

Question 48

What is SECONDARY Addison disease?

Answer 48

-Hypothalamic or pituitary nonfunction

Question 49

If a patient is at risk for cardiovascuar callapse due to Addison Crisis what would be the treatment?

Answer 49

CORTISOL

Question 50

What would be needed for the post-op patient on long term steroid use?

Answer 50

Hydrocortison 50-100mg IV (ADULTS)