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203: Reproduction and endocrinology > T1 L4:Calcium Homeostasis > Flashcards

T1 L4:Calcium Homeostasis Flashcards

1
Q

what are the 3 layers of the adrenal gland

A

The Fasciculata

Glomerulosa

Reticularis

Medulla

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2
Q

what are the adrenal causes of hypertension

A

Primary Hyperaldosteronism/conns syndrome

Adenoma

Rare genetic causes )

Phaeochromocytoma

Congenital adrenal hyperplasia

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3
Q

what zone is primary hyperaldosteronism in

A

Zone glomerulosa

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4
Q

what are the main causes of Hyperaldosteronism

A

Adenoma

Hyperplasia

Rare genetic causes

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5
Q

what is Phaeo-

A

Tumour of the adrenal medulla -some forms of the congenital adrenal hyperplasia

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6
Q

what is Angiotensinogen made by

A

Liver

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7
Q

what converts angiotensinogen to angiotensin 1

A

Renin

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8
Q

what is renin released by

A

kidney

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9
Q

what coverts angiotensin 1 to 2 and made by what organ

A

ACE and by the lungs

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10
Q

what are the effects of angiotensin 2 on AT 2 receptor

A

Vasodilation

ADH seceretion

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11
Q

what are the effects of angiotensin 2 on AT 1 receptor

A

Vasoconstriction

sympathetic activation

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12
Q

what is another name for primary hyperaldosteronism-

A

Conns syndrome

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13
Q

what group of people do we screen for conn’s disease

A
  • Hypokalaemia
  • Resistant hypertension ( 3 drugs )
  • Younger people
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14
Q

what is Primary hyperaldosteronism (PA)

A

Individuals with PA have more vascular and renal pathology than people with Essential Hypertension & similar Blood pressure

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15
Q

what are the initial screening tests for primary hyperaldosteronism

A

Supressed Renin

Normal / High Aldosterone

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16
Q

what is the confirmatory test for primary hyperaldosteronism

A

Oral or IV Na+ suppression test

17
Q

what are the Primary HyperaldosteronismTests for specific Aetiologyi.e secreting Adenoma or bilateral Hyperplasia

A

Adrenal CT scan
Adrenal venous sampling
Is the aldo secretion unilateral?
Metomidate PET CT

18
Q

how do you treat a Unilateral adenoma

A

Laparoscopic Adrenalectomy

Medical Treatment ( sometimes )

19
Q

how do you treat a Bilateral Hyperplasia

A

Medical Treatment

Aldosterone Antagonists
Spironolactone
Eplerinone

20
Q

what structures innervate the adrenal medulla and its blood supply

A

the preganglionic and postganglionic nerve fibres

21
Q

what is the process of sympathetic stimulation of the adrenal medulla

A

Tyrosine- converts L-Dopa to dopamine which is released

Dopamine is converted to noradrenalin and noradrenalin is converted to adrenalin which is released

22
Q

what are the 2 main products of the adrenal medulla

A
  • dopamine
  • Norepinephrine (Noradrenalin)
  • (created via the above + cortisol)Epinephrine
23
Q

what hormone causes the conversion of norepinephrine into epinephrine

A

Cortisol

24
Q

what are the biological effects of catecholamine’s noradrenalin

A

Noradrenalin (alpha 1 & 2 ):

  • vasoconstriction-increased BP,Pallor
  • Glycogenolysis
25
Q

what are the biological effects of catecholamine’s adrenalin

A

Adrenalin (Alpha 1, Beta 1 &2)

  • vasoconstriction
  • Vasodilation in the muscle
  • increased heart rate
  • sweating
26
Q

what are the presentations (signs) of Phaeochromocytoma

A

“Spells”
Headache, Sweating
Pallor, Palpitation
Anxiety

Hypertension
Permanent
Intermittent

Family history

27
Q

what is MEN

A

Multiple endocrine neoplasia

28
Q

what is NF

A

Neurofibromatosis

29
Q

what are the genetic conditions associated with Phaeochromocytoma

A

NF1

MEN 2

Von Hippel-Lindau
syndrome

30
Q

what Biochemical tests can be used to diagnose Phaeo

A

24 hour urine
- 3 Methoxytyromine

Plasma - nor/adrenalin

Both- test for metanephrines

31
Q

what are the other causes of high catecholamine levels

A

Obstructive Sleep Apnoea
Amphetamine like drugs
L-DOPA
Labetalol

32
Q

can you measure dopamine in the urine for Phaeos

A

No as It comes from the kidney and NS

33
Q

what can you measure instead of dopamine in the urine

A

urine Methoxytyramine

34
Q

what can you use to mnage Phaeos

A

-Alpha blockers- Doxazocin & phenoxybenzamine

-Beta blockers
such as propranolol

-Laparoscopic adrenalectomy

203: Reproduction and endocrinology (53 decks)

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