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Endocrine > Section 5 - Adrenal Glands > Flashcards

Section 5 - Adrenal Glands Flashcards

1
Q

Location of adrenal glands?

A

located in the retroperitoneal cavity above each kidney. Right gland is shaped like a pyramid whereas the left is semilunar in shape and larger of the two. Glands are surrounded by fat and enclosed in the renal fascia

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2
Q

adrenal cortex

A

outer layer of adrenal galnds. There are three zones, and this makes up 80% while the medulla only makes up 20%

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3
Q

adrenal medulla

A

inner layer of the adrenal gland. secretes catecholamines and contains only chromaffin cells

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4
Q

adrenal capsule

A

outer layer of the adrenal glands

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5
Q

three zones of adrenal glands?

A

zona glomerulosa, zona fasiculata and zona reticularis

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6
Q

zona glomerulosa

A

mineralcorticoids (aldosterone is the specific one) which helps decrease potassium, increase sodium, and increase blood volume and pressure

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7
Q

zona fasiculata

A

secretes glucocorticoids but cortisol is the most important one

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8
Q

zona reticularis

A

secretes androgens (specifically DHEA and androstenedione)

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9
Q

chromaffin cells

A

secretes epinephrine and norepinephrine

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10
Q

ACTH

A

adrenocorticotropin hormone

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11
Q

chemistry of hormone of ACTH?

A

peptide hormone

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12
Q

stimulation of ACTH?

A
  • decreased blood cortisol
  • sleep-wake transition
  • stress
  • ADH
  • psychiatric disturbances
  • alpha-adrenergic agonists
  • beta-adrenergic antagonists, serotonin
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13
Q

inhibition of ACTH?

A
  • opioids
  • increased blood cortisol levels
  • somatostatin
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14
Q

when and where and how is ACTH synthesized?

A

synthesized and secreted by corticotrophs in anterior pituitary

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15
Q

physiological effects of ACTH?

A

stimulates release of glucocorticoids in adrenal glands

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16
Q

what is the chemistry of the hormone, glucocorticoids or corticosteroids (namely cortisol)?

A

steroid hormone

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17
Q

what stimulates glucocorticoids or corticosteroids (namely cortisol)?

A

it is stimulated by ACTH, from the anterior pituitary

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18
Q

when, where and how is glucocorticoids or corticosteroids (namely cortisol) synthesized?

A

secreted throughout the day in pulsatile manner. is synthesized in zona fasciculata

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19
Q

what are the physiological effects of glucocorticoids or corticosteroids (namely cortisol)?

A
  • increased glucose production by liver
  • increased protein breakdown
  • increase fat breakdown
  • suppression of immune responses
  • inhibits bone formation
  • maintains/promotes increases in GFR, anti-inflammatory effect by inhibiting production of many inflammatory mediators
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20
Q

what is the chemistry of hormone of mineralcorticoids? (namely aldosterone)

A

steroid hormone

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21
Q

stimulation and inhibition of secretion of hormone:

A

drop in blood volume

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22
Q

where, when and how is mineralcorticoids synthesized?

A

synthesized in zona glomerulosa

23
Q

physiological effect of mineralocorticoids?

A

increases reabsorption of Na+ by kidneys. Increases K+ and H+ excretion. Ultimately leads to elevated blood pressure.

24
Q

where are androgens (namely DHEA and androstenedione) synthesized?

A

in the zona reticularis

25
Q

physiological effects of androgens?

A

secretes testosterone. Doesn’t really do much for men or women since in men, we get majority of testosterone from testes. Women, still doesn’t really have a large affect.

26
Q

what is the chemistry of catecholamines (namely epinephrine and norepinephrine)

A

steroid hormones

27
Q

where are catecholamines made?

A

adrenal medulla

28
Q

what is the pathophysiology of cushing syndrome?

A

excess cortisol being produced

29
Q

What is the etiology of cushing syndrome?

A

problem in adrenal cortex, typically a tumor

30
Q

Cushing disease is due to?

A

excess cortisol being prdouced; not due to adrenal cortex but excess ACTH being secreted by anterior pituitary due to a tumor

31
Q

Clinical manifestations of cushing syndrome

A
  • truncal obesity
  • moon face
  • ruddy complexion
  • buffalo hump
  • hyperglycemia
  • osteoporosis
  • hypertension
  • thin extremities
32
Q

Treatment of cushing syndrome?

A

surgery

33
Q

Dental aspects of cushing syndrome?

A
  • round, moon face
  • ruddy color of facial skin
  • acne
  • hirsutism
  • mouth related immunosuppresion -> oral candidias
  • mouth sores
  • recurrent herpes zoster infections
  • impaired wound healing
  • gingival and periodontal disease
34
Q

Primary adrenal insufficiency (Addison’s Disease) pathophysiology?

A

decreased cortisol secretion

35
Q

Etiology of primary adrenal insufficiency?

A

autoimmune disease or certain fungal infections (TB). Autoimmune disease is developed in countries while developing countries, it’s tuberculosis. Can be due to metastatic carcinoma.

36
Q

Clinical manifestations of primary adrenal insufficiency?

A
  • hyperpigmentation
  • metabolic acidosis
  • hyperkalemia
  • hypotension
  • weakness
  • anorexia, weigh loss, nausea, vomiting
37
Q

Treatment of primary adrenal sufficiency?

A

replacement of glucocorticoids and mineralcorticoids. Doses may need to be doubled/tripled under major stress

38
Q

What are two medications for treatment of primary adrenal sufficiency?

A

hydrocortisone - oral cortisol

fludrocortisone - mineralcorticoid

39
Q

Dental aspects of primary adrenal insufficiency?

A

Diffuse, patchy brown pigmentation of oral mucosa.
Increased pigmentation of mucocutaneous junctions including lips, gingival margins, buccal mucosa, palate, and lingual surface of the tongue

40
Q

Pheochromocytoma pathophysiology?

A

high levels of epinephrine

41
Q

Etiology of pheochromocytoma

A

tumor in adrenal medulla

42
Q

clinical manifestations of pheochromocytoma

A
  • hypertension
  • headache
  • diaphoresis (sweating)
  • weight loss & hypermetabolism
  • nervousness & anxiety
  • palpitation - fast beating heart
  • hyperglycemia
43
Q

treatment of pheochromocytoma

A

surgery

44
Q

conn syndrome is aka

A

primary hyperaldosteronism

45
Q

pathophysiology of conn syndrome?

A

hypertension and hyperkalemia

46
Q

etiology of conn syndrome?

A

tumor

47
Q

clinical manifestations of conn syndrome?

A

muscle weakness, fatigue, and cramps

48
Q

treatment of conn syndrome?

A

involves spironolactone (aldosterone antagonist) and surgical removal of aldosterone-secreting tumor

49
Q

adrenal crisis aka

A

addisonian crisis

50
Q

etiology of adrenal crisis

A

serious infection or other acute, major stress to patient with primary adrenal insufficiency. not enough glucocorticoids taken due to stress

51
Q

clinical manifestations of addison crisis

A 
HYPOTENSIVE SHOCK
anorexia
nausea
weakness
fatigue
lethargy
fever
confusion
coma
52
Q

treatment of addison’s crisis

A

immediate infusion of cortisol with supportive care

53
Q

dental aspects of addison’s crisis

A

diffuse, patchy brown pigmentation of oral mucosa

increased pigmentation of mucocutaneous junctions including lips, gingival margins, buccal mucosa, palate, and lingual surface of the tongue

Endocrine (6 decks)

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