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Clinical Science > Lecture 13: Adrenal Gland > Flashcards

Lecture 13: Adrenal Gland Flashcards

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1
Q

What are mineralocorticoids, glucocorticoids, and androgen estrogens synthesized from?

A

cholesterol

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2
Q

What stimulates the release of cortisol from the adrenal cortex?

A

stress acting on the hypothalamus which eventually causes the pituitary gland to release ACTH to the adrenal cortex

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3
Q

How is a dexamethasone suppression test performed?

A

low dose test- give .5mg dexamethasone every 6 hours for 8 doses

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4
Q

What is the most useful test for adrenal insufficiency?

A

ACTH stimulation test

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5
Q

What is a normal response for an ACTH stimulation test?

A

a cortisol level > 20 mg/dl

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6
Q

How does an ACTH stimulation test work?

A

250 mg of Cortrosyn or Cosyntropin are given and serum cortisol is measured 60 minutes later

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7
Q

What is an ACTH stimulation test result that is consistent with Addison’s disease?

A

pre ACTH cortisol is low and post ACTH cortisol is low

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8
Q

What is CRH stimulation test used to differentiate?

A

primary and secondary adrenal insufficiency

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9
Q

What are the CRH stimulation test results in primary adrenal insufficiency?

A

elevated ACTH but no cortisol production

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10
Q

What are the CRH stimulation test results in secondary adrenal insufficiency?

A

low ACTH and Low cortisol

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11
Q

What is the most important test to diagnose hyper and hypoaldosteronism?

A

aldosterone concentration

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12
Q

how can aldosterone concentration be measured?

A

serum or urine

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13
Q

What other test should be used besides aldosterone concentration when screening for primary aldosteronism?

A

renin activity level (PRA)

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14
Q

What factors can affect aldosterone concentration?

A

potassium level, sodium level, inactivity, drugs

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15
Q

What does plasma renin activity measure?

A

ability to convert angiotensinogen to angiotensin I

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16
Q

What are elevated Plasma Renin Activity results seen in?

A

hyperaldosteronism

17
Q

What are signs ad symptoms of Cushing’s Syndrome?

A

rapid weight gain, moodiness, irritability, depression, muscle weakness, osteoporosis, diabetes mellitus, hypertension, immunosuppression, hair pattern changes, amenorrhea, infertility, buffalo hump, abdominal striae, adrenal tumor or hyperplasia, skin ulcers, poor wound healing

18
Q

What happens to the levels of ACTH in cushing’s syndrome

A

excess production of ACTH by pituitary

19
Q

What are the different types of cushing’s syndromes?

A

pituitary adenoma, ectopic ACTH, adrenal tumors, familial cushing’s, drug related

20
Q

What is step one for diagnosing cushing’s syndrome?

A

look for high cortisol level by taking 24 hour urine cortisol and salivary cortisol

21
Q

What is step two in diagnosing cushing’s syndrome?

A

finding the level of the problem; dexamethasone suppression test; CRH stimulation test to distinguish between pituitary and hypothalamus

22
Q

What is step 3 in diagnosing cushing’s syndrome?

A

looking for treatable causes by CT, MRI for tumors

23
Q

When should you check ACTH level for adrenal insufficiency?

A

when cortisol level is the highest (late morning)

24
Q

When is the best time to measure ACTH for cushing’s syndrome?

A

when cortisol is low (midnight to 2am)

25
Q

What is the most important test to diagnose hyper and hypoaldosteronism?

A

aldosterone concentration

26
Q

What are the causes for high cortisol?

A

taking steroids, diseases that cause excess cortisol, ACTH or CRH, tumors

27
Q

What are the cushing’s syndromes?

A

pituitary adenomas, ectopic ACTH, adrenal tumors, familial, familial cushing’s, drug related

28
Q

What are some clinical manifestations of ACTH Deficiency?

A

nausea, vomiting, weakness, fatigue, fever, hypotension

29
Q

What are some causes of a destruction of the adrenal cortex?

A

autoimmune disorders, tuberculosis, chronic infections

30
Q

What are some secondary causes for a lack of ACTH?

A

drugs, tumors and infections of pituitary gland

31
Q

What are two major things that are affected with a primary destruction of the adrenal cortex?

A

low cortisol and low aldosterone

32
Q

What differentiates Addison’s disease?

A

aldosterone

33
Q

how does hypertension affect blood potassium?

A

it decreases blood potassium

34
Q

What happens when a person has low blood potassium?

A

tiredness, muscle weakness, polyuria

35
Q

What are some common causes of secondary hyperaldosteronism?

A

CHF, nephrotic syndrome, Cirrhosis

36
Q

What are the male symptoms of congenital adrenal hypoplasia?

A 
Enlarged penis	
Failure to regain birth weight
Weight loss
Dehydration
Vomiting
Precocious puberty
Rapid growth during childhood, but shorter than average final height.
37
Q

What are the female symptoms of congenital adrenal hypoplasia?

A 
Ambiguous genitalia
Failure to regain birth weight
Weight loss
Dehydration
Vomiting
Precocious puberty
Rapid growth during childhood, but shorter than average final height.
Infertility
Irregular or absent menstruation 
Masculine characteristics

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