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2=Endocrinology > L2 - Adrenal glands/adrenal gland dysfunction/Exogenous Steroid > Flashcards

L2 - Adrenal glands/adrenal gland dysfunction/Exogenous Steroid Flashcards

1
Q

2 parts of adrenal gland

A

cortex and medulla

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2
Q

where are adrenaline and noradrenaline produced in the adrenal gland?

A

medulla

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3
Q

which NS is the medulla part of?

A

sympathetic

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4
Q

3 layers of cortex?

A

Zona
Glomerulosa
Fascicula
Reticularis

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5
Q

which hormones are produced in cortex?

A

corticosteriods

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6
Q

3 types of hormones produced in cortex - according to layers?

A 
G = salt = mineralcorticoid; aldosterone 
F = sugar = glucocorticoid; cortisol 
R = sex = gonadocorticoids; adrenal sex hormones
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7
Q

what type of hormone is aldosterone? why?

A

anti-duiretic - increased Na+ reabsorption, therefore water reabs. and increased in K+ output

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8
Q

what causes the release of all the hormones from the adrenal gland?

A
  1. hypothalamus
  2. anterior pituary releases ACTH (adreno-cortico tropic hormone)
  3. stimulates adrenal gland to release hormones
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9
Q

4 adrenal gland dysfunctions

A
  1. addisons disease
  2. cushings syndrome
  3. hyperaldostronism (Conn’s syndrome)
  4. androgenital syndrome
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10
Q

what is hyperaldosteronism?

A

excess aldosterone - increased Na+ causing hypertension and low K+ levels

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11
Q

what is androgenital syndrome?

A

excess production of gonadocorticoids

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12
Q

what are the sxs of androgenital syndrome

A

female hirsutism = facial hair
male psuedohermaphroditism in female infants
precocious puberty = reaching puberty earlier

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13
Q

cause of androgenital syndrome

A

defect in an enzyme in corticol steriodogenic pathway

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14
Q

what is addisons disease?

A

lack of aldosterone and cortisol production

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15
Q

addisons disease sxs

A
  • chronic fatigue
  • muscle weakness
  • decrease appetite and weight
  • skin hyperpigmentation
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16
Q

which 2 drugs are treatment for addisons?

A

fludrocortison - to replace aldosterone

hydrocortisone - to replace loss of cortisol

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17
Q

what is cushings syndrome?

A

excess glucocorticoid hormone production

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18
Q

ACTH stimulates the adrenal cortex to release what?

A

corticosteriods

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19
Q

what area of the adrenal gland prodcues aldosterone?

A

cortex

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20
Q

Damage to cells of the zona fasciculata of the adrenal cortex would result in

a) the loss of axillary and pubic hair.
b) increased volume of urine formation.
c) decreased levels of sodium ion in the blood.
d) decreased ability to convert amino acids to glucose.

A

d - main effects of cortisol is to promote gluconeogenesis

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21
Q

A rise in cortisol would cause an increase in each of the following, EXCEPT

a) the rate of glucose synthesis by the liver.
b) the level of fatty acids in the blood.
c) fatty acid metabolism by muscle cells.
d) corticotrophin levels.

A

d

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22
Q

syndrome which is a cause of secondary hypertension

A

conn’s syndrome

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23
Q

sxs and symptoms of this disease are moon face, osteoporosis, central body obesity, glucose intolerance

A

cushings disease

24
Q

drug which is also called hydrocortisone

A

cortisol

25
Q

glucocorticoid which is a prodrug with a short duration of action

A

deflazacort

26
Q

most common glucocorticoid drug used as anti-inflammatory and immunusupression

A

prednisolone

27
Q

drug used in addisons disease in conjuction with cortisol

A

fludocortisone

28
Q

2 times in the day where cortisol secretion peaks

A
  1. early morning

2. noon

29
Q

3 mechanisms which control release of aldosterone?

A
  1. stress
  2. decreased Na+ and increased K+ in blood
  3. decreased BP/blood volume
30
Q

how does stress cause release of aldosterone ?

A
  1. hypothalamus detects
  2. releases corticotropin releasing hormone (CRH)
  3. ant pit releases ACTH
31
Q

how does decreased Na+ and increased K+ in blood cause release of aldosterone?

A

direct effect

32
Q

how does decreased BP/blood volume cause release of aldosterone?

A
  1. detetced by kidney
  2. kidney releases renin
  3. cascade produces angiotensin II
33
Q

what hormone works to decrease BP etc?

A

ANP

34
Q

4 general functions of glucocorticoids?

A
  1. metabolic
  2. permissive
  3. adaptation to stress
  4. anti-inflammatory/immunosuppresive
35
Q

3 metabolic effects of cortisol?

A
  1. hyperglycaemia
  2. protein degradation
  3. lipolysis
36
Q

describe 1 permissive effect of cortisol on other hormones?

A

allows catecholamines (NE/E) to induce vasoconstriction

37
Q

in terms of the cortisol short term adaptation to stress - what effects does it have?

A

causes adrenal medulla to secrete Ne E

38
Q

in terms of the cortisol long term adaptation to stress - what effects does it have?

A

same as mineralcorticoid - CRH from hypothalamus etc

39
Q

list 5 ways in which cortisol acts as an anti-inflammatory/immunosuppresive

A
  1. reduce vasodilation and dec fluid exudation
  2. dec number + activity of WBC
  3. dec fibrosis
  4. dec action/proliferation of lymphocytes
  5. dec production of prostanoids/leukotrienes
  6. dec generation of cytokines
  7. dec complement protiens
  8. dec histamine release from mast cells
40
Q

what 2 things can excess glucocorticoid levels lead to?

A
  1. depress bone + cartilage formation

2. promote changes in CV, neural and GI function

41
Q

what does the renin-angiotensin system promote the release of?

A

mineralcorticoids and glucocorticoids

42
Q

when are cortisol levels the highest

A

morning

43
Q

what is conn’s syndrome ?

A

hypoaldosteronism

44
Q

sxs of conns syndrome

A

hypertension - low K+

45
Q

list 5 sxs of cushings syndrome

A
  1. moon face
  2. central body obesity
  3. thin, bruised skin
  4. glucose intolerance
  5. hypertension
  6. excess hair growth
  7. osteoporosis
  8. kidney stones
  9. menstrual irregularity
  10. emotional liability
  11. increased susceptability to infections
46
Q

2 treatments of cushing sundrome

A
  1. surgically remove tumour

2. drugs to inhibit cortisol production

47
Q

3 drugs which inhibit cortisol production

A
  1. metyrapone
  2. trilostane
  3. aminogluethimide
48
Q

common use of steriod drugs

A

anti-inflammatory/immunosuppressive

49
Q

why can cortisone and prednisone only be admisteretd systemically

A

they convert into active form by the liver

50
Q

name 1 short acting corticoid

A

hydrocortisone

51
Q

name 1 intermediate acting corticoid

A

predisone

52
Q

name 1 long acting corticoid

A

betamethasone

53
Q

3 side effects of large doses and long term effects of corticosteroids

A
  1. iatrogenic cushing syndrome
  2. infection/injury suppression - chicken pox
  3. hypothalamic-pit-adrenal suppresion - prevents natural steriods from being produced
54
Q

when can glucocorticoids be abruptly discontinued?

A

if low dose

<3 weeks

55
Q

3 sxs of glucocorticoids withdrawal

A
  1. fatigue
  2. muscle weakness
  3. arthralgia
  4. nausea
  5. hypotension
  6. dizziness

2=Endocrinology (8 decks)

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