Endocrine

Question 1

(started with slide 45)

Cortisol suppresses what as negative feedback?

Answer 1

• Ant pit

- hypothal

Question 2

stress causes increase in what hormone released by hypothal?

Answer 2

Corticotropin Releasing Factor (CRF)

Question 3

adrenal glands sit where in relation to renal fascia?

Answer 3

INSIDE renal fascia

Question 4

blood supply special about adrenal

Answer 4

greatest blood supply per gram of tissue of any organ

Question 5

three blood supplies to adrenal

Answer 5

SUPRARENAL ARTERIES

1) superior (from infer phrenic a.)
2) middle (from aorta)
3) inferior (from renal a.)

Question 6

blood FROM adrenals to?

Answer 6

L to L renal vv

R to IVC

Question 7

what levels of spine do sympathetic nerve fibers come from to innervate ADRENAL MEDULLA?

Answer 7

T5-T11

Question 8

what type of fibers are these? (pre/post)

Answer 8

PRE-ganglionic nn fibers

Question 9

three things secreted by Adrenal Medulla?

Answer 9

• Epi (80%)
• NE (20%)
• dopamine (small)

Question 10

Adrenal CORTEX

three zones

Answer 10

• glomerulosa
• fasciculate (largest - 80%)
• reticularis

GFR
salt, sugar, sex

Question 11

produced in Glomerulosa

Answer 11

mineralocorticoids
–aldosterone
(regulate BP and electrolyte balance)

Question 12

produced in Fasciculata?

Answer 12

Glucocorticoids
–cortisol
(reg metal and immune cyst suppression)

Question 13

produced in reticularis?

Answer 13

Androgens

–converted to functional sex hormones in gonads

Question 14

cortisol effects?

Answer 14

• free water loss
• glucoNEO
• protein wasting
• maintain BP and vasc tone
• large doses BIND mineralocorticoid receptors

Question 15

what does cortisol suppress?

Answer 15

• ACTH from pituitary

- CRF from hypothal

Question 16

how corticoids anti-inflame?

Answer 16

-lysosome stabilization
-maintain capillary integrity
(leukocyte response to local inflammation diminished)

Question 17

glucocorticoids in HIGH doses does what?

Answer 17

-mineralocorticoid effect

Question 18

aldosterone causes reabs of what? excretion of what?

Answer 18

• reabs Na/H2O

- excrete K+ and H+

Question 19

PRIMARY adrenal insufficiency d/t what causes?

Answer 19

• autoimmune
• hemorrhage
• infarcion
• infection

Question 20

SECONDARY adrenal insuffic from?

Answer 20

exogenous steroids
(>7.5mg/day for >3wks)
-can suppress for YEAR!

Question 21

sxs of adrenal insuffic?

Answer 21

• weak, fatigue, anorexia, n/v, flank pain

- fever, AMS, dehydration

Question 22

WHAT TEST for adrenal insuffic?

Answer 22

• have LOW cortisol

- ACTH stim test gives NO response

Question 23

electrolyte abnormals for Adrenal insuff?

Answer 23

• low Na
• low gluc
• HIGH K+

Question 24

excess steroids known as?

Answer 24

CUSHING syndrome

-fat trunks, thin extremities

Question 25

COMMON cause of cushings?

Answer 25

Ant pit micro-adenoma (get bilateral adrenal hyperplasia)

Question 26

dx of cushings with?

Answer 26

• Dex suppression test
• ACTH level
• urinary 24h

Question 27

Primary hyperaldosteronism?

Answer 27

• hypertension (diast)
• HYPOkalemia
• alkalosis
• skel mm weak

-NO EDEMA

Question 28

lab dx for prim hyperaldost?

Answer 28

aldost/renin ratio

renin levels disting primary from secondary

Question 29

Tx for PRIMARY hyperaldost?

Answer 29

Spironolactone

• -aldost antag
• -replete K
• -restrict Na

Question 30

MAIN part of pancreas is which part?

Answer 30

EXOCRINE

acinar cells