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PHCY 310 > L 52 > Flashcards

L 52 Flashcards

1
Q

What glands are involved in the endocrine system?

A
  1. Hypothalamus
  2. Pituitary gland
  3. Thyroid gland
  4. Parathyroid glands
  5. Adrenal glands
  6. Testis/ovaries
  7. Pancreas
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2
Q

What is an endocrine gland?

A

A ductless/tubeless organ/group of cells that secrete hormones directly into the bloodstream which act as chemical messengers

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3
Q

The pituitary gland is known as the …Why?

A

The pituitary gland is known as the master gland as it controls most of the activity of the endocrine glands.

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4
Q

Where are the adrenal glands located?

A

On top of the kidneys

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5
Q

What is one of the major functions of the adrenal glands?

A

Responding to stress

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6
Q

What are the 2 parts of the adrenal glands?

A

Adrenal cortex and adrenal medulla

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7
Q

What are the 3 zones that the adrenal cortex is divided into?

A

Zona glomerulosa
Zona fasciculata
Zona reticularis

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8
Q

What hormones are secreted in the zona glomerulosa?

A

Mineralocorticoids: Aldosterone and corticosterone

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9
Q

What hormones are secreted in the zona fasciculata?

A

Glucocorticoids (cortisol and cortisone)

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10
Q

What hormones are secreted in the zona reticularis?

A

Androgens (estrogen and testosterone)
If a bear was chasing you, which area of the adrenal gland would have released hormones?
The medulla (catecholamines - adrenaline & noradrenaline)

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11
Q

The adrenal cortex is the … portion of the adrenal gland that secretes … hormones.

A

The adrenal cortex is the outer portion of the adrenal gland that secretes steroid hormones.

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12
Q

What hormones are released in the medulla?

A

Catecholamines and peptides.

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13
Q

What type of hormone is aldosterone?
What does it do?
Low amounts of aldosterone =

A

A mineralocorticoid.
It helps to maintain salt and water levels in the body to regulate blood pressure.
Low amounts of aldosterone causes kidney to lose excessive sodium and water = dehydration and low blood pressure.

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14
Q

Where are androgens secreted from?

A

Adrenal cortex

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15
Q

Effects of cortisol:

A

Stimulates glucose production by breaking down stores of fat and glycogen. Also has anti-inflammatory effects

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16
Q

What would your body be releasing in the following situations:

A
  • The night before a big test
  • Not eating well all semester and getting sick
  • The night before a big test: noradrenaline/adrenaline (short term stress)
  • Not eating well all semester and getting sick: cortisol (long term stress)
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17
Q

Short term stress response symptoms x3

A
  • Increased blood glucose
  • Increased blood pressure
  • Increased breathing and metabolic rates
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18
Q

Long term stress response symptoms?
Mineralocorticoids x2
Glucocorticoids x2

A

Mineralocorticoids: Sodium and water retention. Increase blood volume and pressure
Glucocorticoids: protein and fat breakdown to glucose, suppressed immune system.

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19
Q

What is the pathway to cortisol release?

A
  1. Cortisol levels fall
  2. Hypothalamus releases CRH (corticotrophin releasing hormone)
  3. Ant pit releases adrenocorticotropic hormone
  4. Adrenal cortex releases cortisol
  5. Cortisol acts via negative feedback on ant pit and hypothal.
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20
Q

When the levels of cortisol in the blood increase which areas of the brain detect this and decrease the secretion of ACTH via negative feedback loop?

A

Both the hypothalamus and the pituitary

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21
Q
  • The adrenal glands are endocrine glands located …
  • They are responsible for releasing three classes of hormones: … … and … along with …
  • Each adrenal gland is composed of two structures … and …
A
  • The adrenal glands are endocrine glands located on top of the kidneys.
  • They are responsible for releasing three classes of hormones; mineralocorticoids, glucocorticoids, and androgens along with catecholamines.
  • Each adrenal gland is composed of two structures: the adrenal medulla and adrenal cortex.
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22
Q

Adrenal cortex: The … portion of the adrenal glands that produces … … and …
Adrenal medulla: The … part of the adrenal gland, consisting of cells that secrete … and …

A

Adrenal cortex: The outer portion of the adrenal glands that produces mineralocorticoids, glucocorticoids, and androgens.
Adrenal medulla: The innermost part of the adrenal gland, consisting of cells that secrete adrenaline and noradrenaline.

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23
Q

What do the hormones of the adrenal glands play a role in? x7

A 
Reactions to stress
Controlling blood sugar
Burning protein and fat
Developing male and female sex organs
Regulating blood pressure
Initiating the fight and flight response
Regulating skin pigmentation.
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24
Q

Why would the doctor mention a patients adrenal glands when he was seeing them about asthma?

A

Prednisone, for asthma treatment, mimics the natural cortisol produced by the adrenal glands

25
Q

What is an adrenal crisis?

A

Severe adrenal insufficiency resulting in dangerously low serum cortisol levels

26
Q

What are the signs and symptoms of an adrenal crisis?

A

Confusion
Sudden abdo pain
Fever
Vomiting

27
Q

Define cushings disease?

A

Excessive cortisol due to a pituitary tumour causing increased ACTH hormone release (adrenocorticotropic hormone, which acts on the adrenal gland to produce cortisol)

28
Q

Define cushings syndrome?

A

Any condition that causes the adrenal gland to produce excessive cortisol

29
Q

Define Addison’s disease. What is it clinically shown by?

A

Primary adrenal insufficiency, caused by a failure of the adrenal glands to produce sufficient/any amounts of cortisol or aldosterone.
Clinically shown by high ATCH but low cortisol levels.

30
Q

Symptoms of addison’s disease

A

No appetite, nausea, abdominal pain, tired, light-headedness, lethargy, sore muscles, dark pigmentation of creases of hands/skin, craving salt/salty foods.

31
Q

Craving salt is a symptom of …

A

Little/no aldosterone

32
Q

Is addison’s disease acute or chronic?

A

It is a chronic condition as it has a gradual onset (the adrenal cells self destruct via an autoimmune disorder) and it requires life long treatment.

33
Q

Define steroid induced adrenal insufficiency?

A

When there is a problem with the hypothalamus, pituitary glands and adrenal glands because of medication that contains cortisol or some type of steroid.

34
Q

Patient: lower leg cramps, serum cortisol is low, ACTH is high, pigmentation increase.
Diagnosis?

A

Addison’s disease

35
Q

True or false:
If a child is given large doses of glucocorticoids for a short period of time or small doses for any period of time, adrenal function will likely resume shortly after cessation of therapy

A

True, the HPA axis won’t completely shut down and adrenal function can resume shortly after therapy cessation.

36
Q

Patient: Moon face, confusion, infected scratch on arm.
Diagnosis: Cushing’s syndrome, How can cushing’s syndrome be caused?

A

Too many steroids cause abnormally high cortisol levels.

37
Q

When does cushing’s syndrome occur?

A

When the body is exposed to excessive amounts of cortisol.
Overproduction (cushing’s disease)
Exogenous overconsumption (cushing’s syndrome)
Treatment for steroid induced cushing’s
Gradual reduction of steroid dose.

38
Q

Cushing’s disease is also known as…

It is treated by …

A

Cushing’s disease is also known as endogenous Cushing’s syndrome (endogenous = tumour inside the body)
It is treated by surgery, medication or radiotherapy.

39
Q

Delayed diagnosis of Cushing’s can lead to …

A

Diabetes and cardiac problems leading to life threatening illnesses

40
Q

Patient: High dose dexamethasone eye drops (post-op) for 8 weeks, slowed growth rate, weight gain, moon face.
Diagnosis:

A

Diagnosis: Cushing’s syndrome

41
Q

Over what period would you taper a steroid treatment dose?

A

Tapering should b 1:1 with the treatment.

E.g if on treatment for 8 weeks, should taper treatment down for 8 weeks following that.

42
Q

Patient: Sore back, can’t lift, excessive hair growth, stretch marks on stomach, insomnia and irritability, muscle weakness, acne, amenorrhea. Medications: mini-pill, ibuprofen and paracetamol only.
Diagnosis:

A

Cushing’s disease/endogenous Cushings. Caused by a tumour in pituitary gland increasing ACTH hormone.

43
Q

Amenorrhea?

A

Absence of menstruation

44
Q

What is the most common cause of Cushings?

A

Overuse of steroids

45
Q

When would Addison’s occur?
When the adrenal glands are damaged and can’t make enough cortisol (and sometimes aldosterone)
Symptoms of Addison’s:
Signs of Addison’s:

A

Weakness, fatigue, hyperpigmentation

Serum: Low Na+, high K+, high ACTH, low cortisol

46
Q

Treatment of adrenal crisis?

A

Glucocorticoids and IV fluids + counselling

47
Q

What can cause adrenal insufficiency to occur rapidly?

A

Rapidly stopping steroid treatment

48
Q

Symptoms of adrenal crisis?

A

Severe lower back/abdomen/leg pain, vomiting/diarrhoea, weakness, confusion, loss of consciousness

49
Q

MoA of steroid induced adrenal insufficiency?

A

Budesonide = steroid therefore gives negative feedback to ant pit and hypothal, therefore produces less CRH and ACTH meaning natural cortisol is not produced (it is supplemented).
Removal of the steroid = no cortisol will be produced for a while.

50
Q

What is the most important thing to do with long term steroid dosing?

A

YOU MUST TAPER THE DOSE AND NOT STOP SUDDENLY.

51
Q

Patient: slurred speech, convulsions, fever, severe vomiting, sudden abdominal pain. Has Crohn’s but no Addison’s disease.
Diagnosis:

A

Adrenal crisis

52
Q

What is the long term stress response mediated by?

A

Mediated by the secretion of CRH from the hypothalamus

CRH triggers an ant pit to release ACTH, which stimulates adrenal cortex to release corticosteroids.

53
Q

Example of a mineralocorticoid

A

Aldosterone

54
Q

Patient: no appetite, nausea, abdo pain, light headed, lethargic, sore muscles, dark pigmentation on creases of hands, craving salt, high ATCH and low cortisol

A

Primary adrenal insufficiency (adrenals not working)

High ATCH and low cortisol suggests Addison’s disease.

55
Q

Px is craving salt and is light headed. A decrease in what hormone would be responsible for this?

A

Aldosterone

56
Q

High ATCH and low cortisol suggests…

A

Addison’s disease

57
Q

What is the less common cause of Addison’s?

A

Infection (e.g Tb, or bacterial/fungal infections)

58
Q

Patient: flu, sudden leg pain, confusion, convulsions, fever, severe vomiting.
What is your action as their friend?
Diagnosis:

A

Call ambulance as this is an acute, life threatening emergency for Patient
Patient has an adrenal crisis

59
Q

Which disease has hyperpigmentation?

A

Addison’s disease

PHCY 310 (65 decks)

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