Adrenal Tutorial

Question 1

what controls the zona reticularis?

Answer 1

RAAS

Question 2

what zones of the adrenal gland are controlled by ACTH?

Answer 2

zona fasciculata

zona reticularis

Question 3

what controls the adrenal medulla?

Answer 3

sympathetic nerves

Question 4

what zone secretes sex hormones?

Answer 4

zona reticularis

Question 5

what zone secretes mineralocorticoids?

Answer 5

zona reticularis

Question 6

what zone secretes catecholamines?

Answer 6

medulla

Question 7

what kind of steroid is cortisol?

Answer 7

glucocorticoid

Question 8

can hormones from the cortex or medulla be stored and synthesised on demand?

Answer 8

medulla

Question 9

what controls the synthesis and release of aldosterone?

Answer 9

angiotensin 2

Question 10

what effect does aldosterone have on NaCl?

Answer 10

increases retention and reabsorption within the kidney

Question 11

why does blood volume increase when aldosterone is released?

Answer 11

it causes NaCl AND water reabsorption

Question 12

what controls aldosterone?

Answer 12

RAAS

Question 13

what increases production of renin?

Answer 13

decreased BP/NaCl/ECF volume

Question 14

renin converts….

Answer 14

angiotensinogen to angiotensin I

Question 15

what is the pathology in conn’s

Answer 15

tumour in zona glomerulosa secretes excess aldosterone

Question 16

what would the concentrations of NaCl and H20 look like in Conn’s?

Answer 16

high

Question 17

what would potassium look like in Conns?

Answer 17

low

Question 18

what clinical sign will present in patients with conns?

Answer 18

hypertension

Question 19

what other condition presents with similar symptoms to conns?

Answer 19

adrenal hyperplasia

Question 20

does adrenal hyperplasia occur bilaterally or unilaterally?

Answer 20

bilaterally most commonly

Question 21

which 2 conditions make up primary aldosteronism?

Answer 21

conns

adrenal hyperplasia

Question 22

is conn’s a unilateral or bilateral problem?

Answer 22

unilateral

Question 23

1st line treatment for conns?

Answer 23

surgery to remove adrenal gland

Question 24

1st line treatment for adrenal hyperplasia?

Answer 24

aldosterone receptor antagonist eg spirinolactone

Question 25

what drug can be given if spirinolactone produces side effects

Answer 25

epleronone

Question 26

why do patients get excess cortisol in cushings?

Answer 26

redistribution of fat to the face

Question 27

what are the effects on the body of a decreased immunity due to cushings?

Answer 27

easy bruising
immunosuppression
poor wound healing

Question 28

increased fat in cushings is due to what?

Answer 28

gluconeogenesis

decreased fat lipolysis

Question 29

why do patients experience proximal myopathy?

Answer 29

increased rate of protein proteolysis

Question 30

what symptoms would ACTH dependent cushings present with that ACTH independent doesnt?

Answer 30

headaches

visual field impairment

Question 31

why can women in cushings get amenorrhea and hirsutism?

Answer 31

sex hormones are also controlled by ACTH as theyre also in the zona reticularis

Question 32

what tests are used to determine the types of cushings causing the patients symptoms?

Answer 32

high dose dexamethasone test

and acth levels

Question 33

Tx for cushings?

Answer 33

1. metyrapone/ketoconazole

2. transphenoidal removal of tumour (ACTH dependent) or bilateral adrenalectomy (independent)

Question 34

triad of features of adrenaline hypersecretion?

Answer 34

hypertension
sweating
headaches

Question 35

GI consequences of adrenaline hypersecretion?

Answer 35

constipation

paralytic ileus of bowel