Endocrine disorders Flashcards
Aldosterone function
hormone your adrenal glands release that helps regulate blood pressure by managing the levels of sodium and potassium in your blood.
Salt: water balance
Targets distal convoluted tubule and collecting duct of nephrons
Causes Na+ to leave tubules
Causes water to leave tubules again, reabsorbed into body
NET effects- dec urine vol, inc blood pressure
Cortisol function
Main stress hormone
Fight or flight
Release promotes gluconeogenesis from fat and protein
In doing so, glucose released into blood, causing blood sugar levels to inc providing energy required to deal with threatening situations
Controlling blood pressure.
Reducing inflammation.
Helping the heart and blood vessels work correctly.
Controlling blood sugar.
Helping the body use food for energy.
Cushing’s disease
Rare disorder resulting from overproduction of cortisol from zona fasciculata.
Cushing’s disease Epidemiology
30 and 50.
It affects both males and females equally.
Cushing’s disease Patho
Adenoma of ant pituitary- inc ACTH causes hypersecretion of glucocorticoids
Adrenal gland tumours- hyperaldosteronism (over-production of aldosterone)
Ectopic- rare. As a result of a tumour which is not in pituitary gland, causes cortisol to be released from zona fasciculata of adrenal cortex
Long term use of cortisol-like steroids
Cushing’s disease S&S
High aldosterone
Redistribution of fat- upper back, chest, face, abdomen
o Water retention
o Inc blood volume
o Dec urine output
o Muscle weakness (typically in arms and thighs)
Development of male characteristics in females
o Cessation of menstrual cycle
Thin and wrinkled
o Inc ease of bruising
o Deep purple stretch marks
o Poor ability to heal
o Hirsutism- condition in which women develop male-like growth of hair on face, chest, back and arms
Lethargic, depression, anxiety
Cushing’s disease Investigations
Cortisol measurement- salivary cortisol levels, urinalysis
Dexamethasone suppression test
Presence of tumours- ant pituitary and adrenal gland tumours detected via imaging- CT or MRI
Cushing’s disease Management
Depends on cause
Steroid medication= reduce intake
Tumour= removal
Addison’s disease
Rare disorder which results from under production of cortisol from zona fasciculate and under production of aldosterone from zona glomerulosa
Addison’s disease Epidemiology
20 and 50.
It is more prevalent in females, with a female-to-male ratio of about 3:1.
Addison’s disease Patho
Autoimmune- body attacks cortex of adrenal glands
TB- bacterial infection that can affect any part of body, mainly- adrenal glands, bones, nervous system. Damages adrenal cortex which interrupts secretion of hormones including cortisol and aldosterone
Long term use of cortisol-like steroids
Addison’s disease S&S
Weight loss
Dec appetite
Low aldosterone
Inc urine output- loss of Na+ (tend to crave salt_, risk of dehydration
Dec blood pressure- inc urea, bradycardia (<50bpm), muscle weakness
Dehydrated/prone to cracking
o Hyperpigmentation
o Impaired healing- mouth ulcers
o Lethargic
o Fatigue
o Dep and anxiety
Addison’s disease Investigations
Initial visual and stats- medical Hx reviewed alongside weight records to identify any unexpected weight loss, blood pressure low, skin discolouration
Cortisol measurements- salivary cortisol levels, urinalysis
ACTH measurements- high levels
Synacthen test- synthetic version of ACTH, blood test taken before and after injection, high synacthen and low cortisol and/or cortisol indicates +ve
Presence of tumours- CT/MRI
Addison’s disease Management
Restoring adrenal function
Depends on cause
Hormone replacement medication if autoimmune
Glucocorticoids
Surgeyr to remove tumour
What can Addisons lead to
Addisionian crisis.
Can develop or worsen over time. Symptoms- very low blood sugar/pressure, severe dehydration, vomiting. Medical emergency
