The Adrenal Glands

Question 1

Where are the adrenal glands located?

Answer 1

Above each kidney

Question 2

Why do the adrenal glands release hormones?

Answer 2

In response to stress

Question 3

What are the two different areas of the adrenal gland?

Answer 3

The adrenal medulla and cortex

Question 4

What hormones does the adrenal cortex release ? and give a example

Answer 4

Glucocorticoids e.g. cortisol

Mineralcorticoids e.g. aldosterone

Sex steroids e.g. testosterone

Question 5

What hormones does the medulla secrete?

Answer 5

Epinephrine and norepinephrine

Question 6

What does Glucocorticoids do?

Answer 6

Regulates blood sugar

Question 7

What does cortisol do?

Answer 7

Increases blood glucose and increases free fatty acids and suppresses inflammation

Question 8

What dopes Mineralocortocids (aldosterone) do?

Answer 8

Increase K+ secretion and Na+ uptake by kidneys

Question 9

What does Androgens (DHEA)do?

Answer 9

Influences secondary sexual characteristics and sexual behaviour

Question 10

What does epinephrine/norepinephrine do?

Answer 10

Fight and flight response

Question 11

What are the actions of cortisol?

Answer 11

Stimulates gluconeogenesis (formation of glucose from non carbohydrate sources) in response to low sugar/starvation

Protein breakdown and liberation of free fatty acids

Immune system suppression

Facilitated stress response

Maintains blood pressure

Maintains normal sleep/wake cycles

Question 12

State the stages of the hypothalamic- pituitary-adrenal axis?

Answer 12

hypothalamus release CRF (corticotrophin releasing factor)-anterior pituitary release ACTH (adrenocorticotrophic hormone)-adrenal cortex release cortisol-increase of blood glucose and pressure and amino acids-negative feedback response that inhibits further release of CRF

Question 13

Give three examples of medical uses of synthetic Glucocorticoids?

Answer 13

Eczema, Asthma and cancer therapy. (and many more)

Question 14

Give three actions of adrenaline/Noradrenaline

Answer 14

Vasoconstriction,
Dilation of bronchi- increases oxygen,
Increases heart rate

Question 15

Name the five triggers for the adrenal glands to produce adrenaline/Noradrenaline

Answer 15

Anxiety, pain, upright posture, exercise, cold

Question 16

What are the three stages of the general adaptation syndrome (GAS)?

Answer 16

Alarm phase
Resistance phase
Exhaustion phase

Question 17

What are the actions of aldosterone?

Answer 17

vascocontrictor
Heart rate stimulator
Endogenous pressor (blood pressure raising) agent

Question 18

What are diuretics?

Answer 18

Substances that promote production of urine

Question 19

What are antidiuretics?

Answer 19

An agent that decreases excretion of water (ADH/vasopressin)

Question 20

Where is ADH secreted from?

Answer 20

The posterior pituitary gland

Question 21

What is Spironolactone?

Answer 21

A K+ sparing diuretic
Competitive antagonist of aldosterone
Prevents aldosterone entering principal cell
Prevents Na+ reabsorption

Question 22

Name three side effects of spironolactone

Answer 22

Dizziness/light headedness

GI dysfunction: diarrhoea, nausea vomiting

Menstrual period changes

Question 23

What is the dexamethasone suppression test diagnose?

Answer 23

Cushing’s Disease

Question 24

What is Cushing’s disease?

Answer 24

Over-functioning of the pituitary gland

Question 25

What are the causes of excess Glucocorticoids?

Answer 25

Excess corticotrophin Hyperplasia of adrenal cortex Pituitary hypersecretion Certain tumours secrete corticotrophins (pancreas) latrogenic causes: certain drug treatments for inflammatory diseases.

Question 26

What are the three sources for endogenous Cushing's disorder?

Answer 26

Pituitary source Adrenal source Other ectopic source: tumour lying outside the pituitary

Question 27

What are three symptoms of Cushing's?

Answer 27

Buffalo hump Moon face Purple skin stretch marks

Question 28

What are the complications of excess Glucocorticoids?

Answer 28

Osteoporosis/fractures Peptic ulcer Lipidosis (disorder of fat metabolism) Impaired glucose tolerance Increase hepatic gluconeogenesis

Question 29

What are medical uses of corticosteroids?

Answer 29

To reduce inflammation To treat allergic reactions In cancer care Treating brain tumours/delicate neurosurgy

Question 30

What are treatments of Cushing's disease?

Answer 30

Gland irradiation Surgery to remove pituitary gland or bilateral adrenalectomy Drugs: corticosteroid antagonist (Metyrapone)

Question 31

What does stereotaxic radiosurgery do?

Answer 31

Damages DNA of target cells to shrink tumours. Minimal impact on healthy tissue

Question 32

What needs to be done if both adrenal are removed?

Answer 32

Lifetime steroid supplementation Hydrocortisone and cortisone Dose needs to be increased in times of stress.

Question 33

What is adrenal hypofunction?

Answer 33

Autoimmune disease in which 90% of gland is destroyed

Question 34

What are three symptoms of adrenal hypofunction/Addisons disease?

Answer 34

Hypoglycaemia and fatigue hyperkalaemia Skin hyperpigmenatation

Question 35

What is the treatment of adrenal hypofunction?

Answer 35

Lifelong corticosteroid replacement with cortisone or hydrocortisone

Question 36

What are treatments of Addison disease?

Answer 36

Combined replacement therapy Glucocorticoids (hydrocortisone) Mineralocorticoids (fludrocortisone)

Question 37

What are side effects of glucocorticoids?

Answer 37

Diabetes, heart disease, Cushing's ect..

Question 38

What are side effects of Mineralocorticoids?

Answer 38

Hypertension, Na+/water retention

Question 39

Name a hydrocorticoid tablet?

Answer 39

Plenidren

Question 40

What action does Plenidren have?

Answer 40

A immediate and extended release action

Question 41

What is Plenidren?

Answer 41

A orally modified release formulation of hydrocortisone Mimics natural cycle of cortisol release Slow release core + fast release exterior