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AP2: Exam 4 > Day 3 Lecture: Adrenal > Flashcards

Day 3 Lecture: Adrenal Flashcards

1
Q

Other name for Addison’s disease

A

Adrenal insufficiency or hypocortisolism

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1
Q

2 common causes of Conn’s Syndrome

A
  1. Unilateral aldosterone-producing adenoma (aldosteronomas) 2. Bilateral adrenal hyperplasia (idiopathic)
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2
Q

High doses and long-term use of methylprednisolone has been associated with the development or exacerbation of ______.

A

Non-alcoholic steatohepatitis.

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2
Q

Causes of Adrenal Disorder (3)

A
  1. Adrenal Hyperplasia (increase cell proliferation) 2. Adrenal neoplasia (tumors: adenoma, carcinoma) 3. Iatrogenic (oral steroids)
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2
Q

A radioactive iodine used to detect Conn tumor (scintigram)

A

I-131-beta-iodomethyl-norcholesterol (NP-59)

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3
Q

Major risk factors for cushing’s syndrome (3)

A

Obese + DM2, Poor glucose control, HTN

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3
Q

Drugs used to treat Congenital Adrenal hyperplasia (3)

A

Dexamethasone, Hydrocortisone, Fludrocortisone

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4
Q

This hormone increases Na and water reabsorption, K secretion

A

Aldosterone

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5
Q

A condition in which a female develops male sex characteristics

A

Virilization

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6
Q

Other name of Adrenal glands

A

Supra-renal glands

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7
Q

Precursor of gonadocorticoids

A

DHEA (dehydroepiandrosterone)

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9
Q

Cellular locations of enzymes (for synthesis of hormones) (2)

A
  1. Mitochondria 2. Smooth ER
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10
Q

This is the most common (70%) cause of Cushing’s syndrome.

A

Cushing’s disease

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11
Q

Embryonic tissue development of adrenal glands

A
  1. Adrenal cortex: mesodermal 2. Adrenal Medulla: neuroectodermal
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11
Q

Most lethal manifestation of acute adrenal crisis.

A

Hypovolemic shock

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12
Q

True or False: The appearance of adrenal glands are similar to para-renal fats.

A

True

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13
Q

How many % of patients with HTN have primary hyperaldosteronism?

A

5 - 15%

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14
Q

Enumerate the signs and symptoms of Cushing’s Syndrome (16)

A
  1. HTN, Obesity, Osteoporosis 2. Moon face, emotional disturbance, muscle weakness 3. Buffalo hump, Amenorrhea, Abd striae, Adrenal tumor/ hyperplasia, thin skin 4. Increased fatigue, glucose, urination/thirst 5. Purpura, skin ulcers
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15
Q

This adrenal steroid has the highest mineralocorticoid activity.

A

Aldosterone

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16
Q

Clinical cues in infants with salt wasting.

A

Weight loss or lack of expected weight gain.

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17
Q

What enzymes are found in the mitochondria? (2)

A

Aldosterone synthase 11 Beta Hydroxylase

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19
Q

This group of hormones has anti-inflammatory effects.

A

Glucocorticoids

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19
Q

This type of adrenal insufficiency happens when there is deficiency in CRH (by hypothalamus)

A

Tertiary Adrenal insufficiency.

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20
Q

Morbidity and mortality associated with primary hyperaldosteronism, are primarily related to ____ and ____.

A

hypokalemia….. HTN

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21
Q

This disease encompasses a group of AUTOSOMAL RECESSIVE disorders, which involves deficiency of an enzyme involved in the synthesis of cortisol and aldosterone.

A

Congenital adrenal hyperplasia

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22
Q

This hormone can be converted to either male or female hormones.

A

Androstenedione

23
Q

Precursor of steroid hormones

A

Cholesterol

25
Q

2 Common causes of Addison’s disease

A
  1. Autoimmune 2. Genetic failure of adrenals to develop
26
Q

This disorder is caused by adenoma (tumor) in the pituitary gland, which produces large amount of ACTH and in turn elevates cortisol.

A

Cushing’s disease

27
Q

True or False: In cortisol excess, cortisol can bind to aldosterone receptor.

A

True

29
Q

CAH in infants: Electrolyte abnormalities generally take from a few days to _____ weeks to appear because the PLACENTA maintains the fetal electrolytes in utero.

A

3 weeks.

30
Q

This type of adrenal insufficiency occurs when the pituitary gland fails to produce enough ACTH. (low ACTH = low cortisol)

A

Secondary adrenal insufficiency

31
Q

This condition has high cortisol levels activating the mineralocorticoid receptor, leading to aldosterone- like effects in the kidney (Increased NA and water retention).

A

Apparent mineralocorticoid excess.

31
Q

Drug used to treat Idiopathic adrenal hyperplasia. It is a mineralocorticoid antagonist.

A

Spironolactone (inhibitory ligands to the mineralocorticoid receptor)

32
Q

This adrenal steroid has highest concentration in plasma.

A

DHEA: Dehydroepiandrosterone.

33
Q

This type of adrenal insufficiency occurs when the adrenal glands are damaged and cannot produce enough cortisol (and aldosterone)

A

Primary adrenal insufficiency

34
Q

Characteristics of Conn’s (4)

A
  1. increase aldosterone secretion from the adrenal glands 2. suppressed plasma renin activity 3. HTN 4. hypokalemia.
35
Q

Name 4 common signs and symptoms of Addison’s disease

A

Decreased libido, Amenorrhea, Hyperpigmentation, Vitiligo

37
Q

This is the enzyme that catalyzes the conversion of cholesterol to aldosterone.

A

aldosterone synthase

38
Q

Causes of Acute adrenal crisis (3)

A
  1. Adrenal hemorrhage 2. Sepsis/ surgical stress 3. Steroid withdrawal – MOST COMMON
39
Q

These levels are increase in plasma as a result of Metabolic effects of cortisol. (3)

A

glucose, free fatty acids, amino acids

40
Q

21 Beta hydroxyls deficiency makes adrenal glands to produce excess androgens, characterized with __ and ___>

A

salt wasting and virilization

42
Q

Symptoms of Conn’s (3)

A
  1. HTN (often the only symptom) 2. Polyuria 3. Nocturia
43
Q

The most common cause of acute adrenocortical insufficiency (adrenal crisis) and glucocorticoid deficiency.

A

Steroid Withdrawal

44
Q

This is the most common type of Addison’s disease.

A

Secondary adrenal insufficiency

45
Q

Common cause of Apparent Mineralocorticoid Excess.

A

11 Beta-hydroxylase deficiency

46
Q

Common cause of congenital adrenal hyperplasia.

A

21 Beta-hydroxylase deficiency

47
Q

What age does puberty begin in children with congenital adrenal hyperplasia?

A

2 - 3 years old

48
Q

Deficiency of 21 hydroxyls, resulting from mutations or deletions of ______, is the most common form of CAH, accounting for more than 90% of cases.

A

CYP21A Cytochrome P450, Family 21, Subfamily A, polypeptide 2

49
Q

Name 3 zones of adrenal cortex and the major hormone they produce.

A
  1. Glomerulosa: Mineralocorticoids (Aldosterone) 2. Fasciculata: Glucocorticoids (Cortisol) 3. Reticularis: Androgens
51
Q

This hormone has equal glucocorticoid and mineralocorticoid activities.

A

Cortisol

52
Q

Shape of Right Adrenal gland… Left adrenal gland

A

R: Pyramid L: Crescent

53
Q

Side effects of steroids may appear as early as ___ weeks

A

2 weeks

54
Q

What hormones are produced by adrenal medulla?

A

Norepinephrine and epinephrine (catecholamines)

55
Q

AKA fatty liver. (It is reversible)

A

Hepatic steatosis.

56
Q

Effects of Long-term use of steroids

A
  1. Cataract 2. Increased glucose 3. Increased risk for infection 4. Thin skin, easy bruising, slow healing 5. Suppressed adrenal hormone production
57
Q

This is a hormonal disorder caused by prolonged exposure of the body’s tissues to high levels of cortisol.

A

Cushing’s syndrome

58
Q

Drug used for treatment of idiopathic adrenal hyperplasia. It has less estrogenic-like effects.

A

Eplerenone

59
Q

Treatment for aldosterenomas

A

Adrenalectomy

60
Q

Apparent mineralocorticoid excess is mimicked by ____.

A

high licorice ingestion

61
Q

Other name for Conn’s syndrome

A

Primary Hyperaldosteronism

62
Q

This synthetic steroid has the highest glucocorticoid activity, therefore it is given to patients to prevent inflammation.

A

Dexamethasone

63
Q

This synthetic steroid has the highest mineralocorticoid activity, therefore it is given to patients with low levels of aldosterone.

A

9 alpha-fluorocortisol

AP2: Exam 4 (4 decks)

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