Endocrine Flashcards
(started with slide 45)
Cortisol suppresses what as negative feedback?
- Ant pit
- hypothal
stress causes increase in what hormone released by hypothal?
Corticotropin Releasing Factor (CRF)
adrenal glands sit where in relation to renal fascia?
INSIDE renal fascia
blood supply special about adrenal
greatest blood supply per gram of tissue of any organ
three blood supplies to adrenal
SUPRARENAL ARTERIES
1) superior (from infer phrenic a.)
2) middle (from aorta)
3) inferior (from renal a.)
blood FROM adrenals to?
L to L renal vv
R to IVC
what levels of spine do sympathetic nerve fibers come from to innervate ADRENAL MEDULLA?
T5-T11
what type of fibers are these? (pre/post)
PRE-ganglionic nn fibers
three things secreted by Adrenal Medulla?
- Epi (80%)
- NE (20%)
- dopamine (small)
Adrenal CORTEX
three zones
- glomerulosa
- fasciculate (largest - 80%)
- reticularis
GFR
salt, sugar, sex
produced in Glomerulosa
mineralocorticoids
–aldosterone
(regulate BP and electrolyte balance)
produced in Fasciculata?
Glucocorticoids
–cortisol
(reg metal and immune cyst suppression)
produced in reticularis?
Androgens
–converted to functional sex hormones in gonads
cortisol effects?
- free water loss
- glucoNEO
- protein wasting
- maintain BP and vasc tone
- large doses BIND mineralocorticoid receptors
what does cortisol suppress?
- ACTH from pituitary
- CRF from hypothal
how corticoids anti-inflame?
-lysosome stabilization
-maintain capillary integrity
(leukocyte response to local inflammation diminished)
glucocorticoids in HIGH doses does what?
-mineralocorticoid effect
aldosterone causes reabs of what? excretion of what?
- reabs Na/H2O
- excrete K+ and H+
PRIMARY adrenal insufficiency d/t what causes?
- autoimmune
- hemorrhage
- infarcion
- infection
SECONDARY adrenal insuffic from?
exogenous steroids
(>7.5mg/day for >3wks)
-can suppress for YEAR!
sxs of adrenal insuffic?
- weak, fatigue, anorexia, n/v, flank pain
- fever, AMS, dehydration
WHAT TEST for adrenal insuffic?
- have LOW cortisol
- ACTH stim test gives NO response
electrolyte abnormals for Adrenal insuff?
- low Na
- low gluc
- HIGH K+
excess steroids known as?
CUSHING syndrome
-fat trunks, thin extremities
COMMON cause of cushings?
Ant pit micro-adenoma (get bilateral adrenal hyperplasia)
dx of cushings with?
- Dex suppression test
- ACTH level
- urinary 24h
Primary hyperaldosteronism?
- hypertension (diast)
- HYPOkalemia
- alkalosis
- skel mm weak
-NO EDEMA
lab dx for prim hyperaldost?
aldost/renin ratio
renin levels disting primary from secondary
Tx for PRIMARY hyperaldost?
Spironolactone
- -aldost antag
- -replete K
- -restrict Na
MAIN part of pancreas is which part?
EXOCRINE
acinar cells
