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hd3 endocrine > Endo 4 - Adrenal Hormones and Disorders > Flashcards

Endo 4 - Adrenal Hormones and Disorders Flashcards

1
Q

3 most important hormones of the adrenal cortex

A

cortisol aldosterone dehydroepiandrosterone

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2
Q

what type of hormone is cortisol

A

glucocorticoid

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3
Q

what type of hormone is aldosterone

A

mineralcorticoid

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4
Q

what type of hormone is DHEA

A

androgen

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5
Q

Hormone axis for cortisol

A

CRH => ACTH => cortisol

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6
Q

T/F stress increases CRH release

A

TRUE

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7
Q

T/F cortisol increases CRH release

A

FALSE (negative feedback)

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8
Q

method of secretion for ACTH

A

pulsing

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9
Q

what can disrupt the pulsing rhythmic secretion of ACTH

A

stress

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10
Q

highest peak of cortisol

A

4-7 AM

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11
Q

ACTH binds and activates what?

A

Adenyl cyclase

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12
Q

acute effect of ACTH

A

immediate removal of 6 C side chain from cholesterol => allows steroid synthesis

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13
Q

chronic effect of ACTH

A

formation of all enzymes involved in steroid synthesis

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14
Q

main controller of aldosterone secretion

A

RAS

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15
Q

direct stimulator of aldosterone secretion

A

ATII

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16
Q

Factors that increase aldosterone secretion

A

decreased afferent arteriolar pressure, decreased filtered sodium to DCT, potassium, ACTH, SNS

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17
Q

major function of cortisol

A

catabolic, gluconeogensis

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18
Q

other things cortisol does

A

glycogen deposition in liver, insulin resistance, anti-inflammatory

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19
Q

Aldosterone promotes sodium (1) by reducing (2)

A

1) retention 2) urinary sodium excretion

20
Q

What is the effect of aldosterone on urinary K and H

A

increases excretion of K and H

21
Q

DHEA function in females

A

axillary and pubic hair

22
Q

Why does DHEA not have much of an effect in males

A

males have testosterone - much more powerful

23
Q

5 major disorders of adrenal glands

A

1) insufficiency 2) hyperfunction (cushing syndrome) 3) primary hyperaldosteronism 4) congenital adrenal hyperplasia (21-H deficiency) 5) pheochromocytoma

24
Q

test for adrenal insufficiency

A

ACTH stimulation test

25
Q

3 screen tests for cushing (hyperfunction)

A

1) bedtime salivary cortisol 2) urine free cortisol 3) overnight 1 mg dexamethasone suppresion test

26
Q

how to test for aldosterone overproduction

A

plasma aldosterone: plasma renin activity ratio > 30 = positive

27
Q

symptoms of addison (insufficiency)

A

weakness, fatigue, hyperpigment, weight loss, anorexia, hypotension, hyponatremia, HYPERkalemia

28
Q

what is secondary adrenal insufficiency

A

ACTH deficiency caused by withdrawal of exogenous steroids, pit tumor

29
Q

major difference between secondary and primary insufficiency

A

pallor instead of hyperpigmentation, no electrolyte abnormalities, loss of axillary and pubic hair

30
Q

major symptoms of cushing

A

weight gain, truncal obesity, weakness, HTN, hirsutism/amenorrhea

31
Q

patients with ectopic (cancer secreting) ACTH have what 2 differences in symptoms

A

weight loss and hyperpigmentation

32
Q

tx of cushing

A

surgery or pharmacologic block of steroid synthesis

33
Q

overnight test for cushing?

A

dexamethasone suppresion

34
Q

what does dexamethasone do?

A

it suppresses the production of cortisol

35
Q

tx for hyperaldosteronism

A

surgery for adrenal adenoma spironolactone/eplerenone for adrenal hyperplasia

36
Q

most common deficiency in CAH

A

21-Hydroxylase

37
Q

2 important hormones of adrenal medulla

A

Epi/NE

38
Q

test to see levels of adrenal medulla

A

metanephrine (metabolite of catecholamine)

39
Q

super rare tumor causing hypertension

A

pheochromocytoma

40
Q

what is a pheochromocytoma

A

catecholamine secreting tumor of the adrenal medulla

41
Q

tx of pheochromocytoma

A

surgery

42
Q

symptoms/signs of pheo

A

HTN, palpitations, tremor, sweating, pallor

43
Q

mass lesion on adrenal gland > 1 cm

A

adrenal incidentaloma

44
Q

first step after discovery of adrenal incidentaloma

A

make sure nodule is not functioning

45
Q

primary adrenal insufficiency has what electrolyte abnormalities?

A

low Na, high K - due to loss of aldosterone function

46
Q

classic presentation for someone w/ primary adrenal insufficiency

A

salt craving

hd3 endocrine (9 decks)

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