Cushings and Addisons Flashcards
Name four causes of cushings syndrome
Prescribed glucocorticoids
Cushings disease- Pituitary adenoma secreting ATCH
Adenoma of the adrenal cortex secreting cortisol
Ectopic adenoma secreting ACTh or cancer secreting ACTH (Small cell lung cancer)
7 symptoms of cushings syndrome?
buffalo hump striae enlarged abdomen moon face hypertension hyperglycaemia
Test for cushings syndrome?
Dexamethosome
inhibits ACTH production from pit gland
If cushings disease cortisol secretion decreases by 50%
If a adenoma in the adrenal gland secreting cortisol or some ectopic secretion of ATCH then it will have no effect on cortisol levels
Where is cortisol secreted?
Zona fasciculata
Carrier protein of cortisol?
transcortin
Where does cortisol act and what effect (Celllar)?
intracellular receptor to regulate gene transciption
4 actions of cortisol
Increased lipolysis
Increased gluconeogenesis
Increased Glycogenolysis
Anti inflammatory effects
What is the 2 stimulus of cortisol secretion?
stress
low blood glucose
What is addison’s disease?
low cortisol
Autoimmune destruction of the adrenal cortex
5 symptoms of addisons disease?
postural hypotension lethargy wieght loss increased skin pigmentation hypoglycaemia
describe why you get the skin pigmentation? Why do you get hypoglycaemia? Why do you get hypotension
because ACTH is produced from POMC
Another product of POMC is MSH (Melanocyte stimulating hormone)
Increased melanin
hypoglycaemia because less cortisol means less gluconeogenesis and less glycogenolysis
weight
Hypotension because less aldosterone secretion so decreased water retention in kidney
Name 4 causes of an addisonian crisis?
trauma
infection
stress
abrupt withdrawal of steroid drugs
name 5 symptoms of addisonian crisis?
collaspe hypotension dehydration pigmentation coma
3 forms of treatment for addisonian crisis?
IV cortisol
Fluid replacement
treat the hypoglycaemia
What is the test for addisons disease?
Synacthen
Synthetic ACTH
should increase Cortisol
doesn’t in addisons disease
