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Endocrine - Dr Troutman > Adrenal Review > Flashcards

Adrenal Review Flashcards

1
Q

What are the suprarenal gland?

A

Adrenal glands

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2
Q

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

A

Stress hormones

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3
Q

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

A

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

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4
Q

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

A

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

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5
Q

The adrenal medulla ________ the endocrine and sympathetic nervous system.

A

bridges

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6
Q

What cells make catecholamines in the adreanl medulla?

A

Chromaffin cells

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7
Q

What are catecholamines derived from?

A

tyrosine

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8
Q

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

A

TRUE

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9
Q

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

A

TRUE

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10
Q

How much epinephrine is made in the adrenal medulla gland?

A

80%

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11
Q

How much norepinephrine is made in the adrenal medulla gland?

A

20%

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12
Q

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

A

TRUE

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13
Q

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

A

Epinephrine

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14
Q

What two type of tumors cause pheochromocytoma?

A
  • Adrenal hyperplasia

- extra-adrenal chromaffine tissue

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15
Q

What are the symptoms of pheochromocytoma?

A
  • paroxysmal hypertension
  • tachycardia
  • headache
  • sweating
  • anxienty
  • tremor
  • glucose intolerance
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16
Q

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

A
  • 10%

- 95%

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17
Q

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

A
  • 85-90%
  • solitary
  • right
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18
Q

What lab level would strongly indicate pheochromocytoma.

A

-Urinary Vanillylmandelic Acid

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19
Q

What does norepinephrine and epinephrine degrade down to?

A

-Urinary vanillylmandelic Acid

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20
Q

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

A

Reduces incidence of:

  • B/P fluctuations
  • MI
  • CHF
  • dysrhythmias
  • CVA
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21
Q

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

A
  • phenoxybenzamine

- prazosin

22
Q

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

A

10-14 days

23
Q

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

A

-Abrupt hypotension

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

24
Q

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

A

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

25
Q

What is the function of the adrenal cortex?

A

-Mediates the stress response

26
Q

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

A
  • mineralocorticoids

- glucocorticoids

27
Q

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

A

TRUE

28
Q

The three layers of the adrenal cortex are:

A
  • Zona glomerulosa (outer)
  • zona fasciculata (middle)
  • Zona reticularis (Inner)
29
Q

What does the zona glomerulosa produce?

A

mineralocorticoids

30
Q

What does the zona fasciculata produce?

A

glucocorticoids

31
Q

What does the zona reticularis produce?

A

Androgens

32
Q

The mineralocorticoids is responsible for ________.

A

Aldosterone

33
Q

The glucocorticoid is responsible for ________.

A

Cortisol

34
Q

The Androgen is responsible for _______.

A

Androstenedione

35
Q

What electrolytes are controlled by the mineralocorticoids?

A
  • Na+

- K+

36
Q

What part of the kidney is affected by aldosterone?

A
  • Distal convoluted tubule

- Collecting ducts

37
Q

What primarily regulates aldosterone?

A
  • Renin-angiotensin system

- Potassium levels

38
Q

What causes primary hyperaldosteronism.

A

TUMOR

39
Q

What causes secondary hyperaldosteronism?

A
  • CHF
  • cirrhosis with ascites
  • Nephrosis
40
Q

What happens if there is adrenal insufficiency?

A
  • Na lost in the urine
  • (K+) retained
  • circulatory collapse
41
Q

T/F: Cortisol is also called ______________.

A

Hydrocortisone

42
Q

Adrenocorticotropic hormone (ACTH) stimulates ________secretion.

A

cortisol

43
Q

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

A

TRUE

44
Q

Where is corticotropin released from?

A

-hypothalmus

45
Q

What is CUSHING disease?

A

-ACTH secreting tumor of the pituitary

46
Q

What is Addison Disease?

A

-Failure to produce adrenocortical hormones

47
Q

What is PRIMARY Addison disease?

A

-adrenal nonfunction mostly autoimmune

48
Q

What is SECONDARY Addison disease?

A

-Hypothalamic or pituitary nonfunction

49
Q

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

A

CORTISOL

50
Q

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

A

Hydrocortison 50-100mg IV (ADULTS)

Endocrine - Dr Troutman (7 decks)

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