T1 L4: Adrenal hypertension Flashcards
What are the 3 causes of hypertension?
- Essential
- Renal
- Endocrine
What is essential hypertension?
Abnormal BP that isn’t caused by a medical condition
What are the 2 renal causes of hypertension?
- Primary renal disease
2. Renal artery stenosis
What is the cause of primary Hyperaldosteronism?
Adenoma, hyperplasia, or a genetic disorder affecting the zona Glomerulosa
What is a Phaeochromocytoma (A Phaeo)?
A tumour of the adrenal medulla that grown in Chromaffin cells
Describe the pathway of aldosterone secretion
Angiotensinogen is released by the liver and renin is released by the kidneys. Renin converts angiotensinogen into angiotensin I and then ACE converts angiotensin I into angiotensin II. Aldosterone is then produced
What is Primary Hyperaldosteronism?
When the adrenal glands produce too much aldosterone
What is Conn’s disease?
Primary Hyperaldosteronism
When should someone with hypertension be screened for Primary hyperaldosteronism (Conn’s disease)?
- Hypokalaemia
- Resistant hypertension
- Younger people
What does Liquorice have to do with aldosterone levels?
It causes aldosterone levels to decrease by reducing Renin
What are the initial screening tests for primary hyperaldosteronism?
Supressed renin and normal/high aldosterone tests
What is the confirmatory test for primary aldosteronism?
Oral or IV Na+ suppression test
Urinary aldosterone is then measured
Normal= low aldosterone
What are some tests for specific aetiology for primary hyperaldosteronism?
- Adrenal CT
- Adrenal venous sampling
- Metomidate PET CT
Under what conditions does cortisol turn norepinephrine into epinephrine?
Where there are high concentrations of cortisol Eg. in the adrenal medulla
What are the biological effects of Noradrenaline?
Vasoconstriction
Glycogenolysis
