Adrenals disorders (Hypo) Flashcards
What is the role of Cholesterol in the adrenals?
Its the precursor for the all adrenal hormones substances-Mineralocorticoiod-aldo, glucocorticoid-cortisol, Estradiol/Sex hormones
What are the 2 main parts of the Adrenals? Where is what produced?
Cortex (Steroids) and medulla (Catecholamines)
Which enzymes can go wrong in the converstion of chol to steroid?
Mostly the hydroxylase that take progesterone to other cases
What are the causes of adrenal dysfunction?
Adrenal failure : Addison’s TB, Autoimmune Addison’s, Congenital Adrenal problem Hyperplasia-Enzymes in steroid pathway broken
What are some general signs of Adrenal hypo function (Adrenocortical failure)?
Aldo related: Postural Hypotension, loss of salt in urine, high blood K,
Cortisol: Vitiligo (not only in addisons-its just AID), Skin pigment/hair pigment, Loss of weight, Anorexia, Muscular weaken, feckle, low gluc, high ACTH (you know why dumass-POMC->ACTH+MSH-pigment)
EVENTUAL DEATH BY HYPOTENSION
What are the main fates of the Adrenal glands in failure?
Atrophy-55% tiny
TB-Adrenal are super granulous-granuloma-40%
Other causes-Large, swollen (cancer)
How do you test for Addison’s?
9am Cortisol Low and ACTH high-but vary in the day (GOT to measure cortisol at 9am (when highest-if low its low)
Low sodium, high Pot, hypotension
Then to be sure:
Synthetic ACTHen test-Give 250ug synth ACTH and measure cortisol response (if addison’s expect nothing)
What is Congenital Adrenal hyperplasia? Describe using a specific exemple?
Missing an enzyme from birth-Can be complete or partial
Commonest from 21-Hydroxylase Deficiency (those are mostly for Aldo/Cortisol)-alllll is funneled to sex hormones (easier if male baby)
These don’t live for long-low sodium, high pot, etc..
What is Partial 21 Hydroxylase deficiency?
Similar to congenital one but have some enzymes working-so enough to grow but as they get older, get symptoms of sex steroids excess
can present at any age, but not as baby
Women-hirsutism, ammenhorea
Men-prepubescent puberty
Women - Can present with large clit/penis thing, small breast, Acne, facial hirsutism,
Why does congenital adrenal hyperplasia results in large Adrenal Glands?
because ACTH drive is so high
What other 2 enzyme can be missing in Congenital Adrenal Hyperplasia?
11 hydrolase
cant make adlo and cortisol
But can make precusors-and these can act like aldosterone-
Lack of Corti, Aldo, lots of sex hormones, high Na, low K, virilisation
17 hydroxylase
Cant make cortisol/sex
Excess aldosterone-hypertension , lowK, sex defi, cortsol deficicent
