Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrinology Y2 > Therapeutic use of Adrenal Steroids > Flashcards

Therapeutic use of Adrenal Steroids Flashcards

1
Q

What is produced in the zone glomerulosa

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is produced in the zone fasciculata

A

cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is produced in the zone reticularis

A

Androgens/oestrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Androgens/oestrogens are produced in which layer of the adrenals?

A

Reticularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

cortisol is produced in which layer of the adrenals?

A

Fasciculata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Aldosterone is produced in which layer of the adrenals?

A

Glomerulosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Order of adrenal layers out to in?

A

GFR (medulla)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what stimulates aldosterone secretion

A

ATII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What stimulates cortisol secretion

A

ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does cortisol inhibit and where

A

ACTH and the Aden-hypophysis and CRH at the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what stimulates ACTH release

A

CRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Principle effects of aldosterone?

A

Promotes Na+ retention and K+ loss via the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What receptors does cortisol act on

A

Glucocorticoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What receptors does aldosterone act on

A

mineralocorticoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

distribution of glucocorticoid receptors

A

Widely in body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

affinity of glucocorticoid receptors for cortisol?

A
  • Selective for glucocorticoids

- Low affinity for cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

distribution of mineralocorticoid receptors

A
  • Discrete distribution (found only in the kidney)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Selectivity of mineralocorticoid receptors?

A
  • Do not have selectivity i.e. bind both aldosterone and cortisol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do mineralocorticoid receptors bind

A

Cortisol and aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Affinity of mineralocorticoid receptors for cortisol?

A

High affinity for cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What protects mineralocorticoid receptors from cortisol? what does it covert it to?

A

11beta-hydorsteroid dehydrogenase

converts to cortisone

22
Q

In Cushings, how does hypernatraemia and hypokalaemia occur

A

In Cushing’s, there’s too much cortisol for the 11beta-hydorsteroid dehydrogenase to deal with, so cortisol does bind to the MRs, leading to sodium retention and hypokalaemia

23
Q

RECEPTOR SELECTIVITY of

Hydrocortisone?

A

Glucocorticoid with mineralocorticoid activity at high doses

24
Q

RECEPTOR SELECTIVITY of

Prednisolone?

A

Glucocorticoid with weak mineralocorticoid activity

25
Q

RECEPTOR SELECTIVITY of

Dexamethasone?

A

Synthetic glucocorticoid with no mineralocorticoid activity

26
Q

RECEPTOR SELECTIVITY of

Fludrocortisone?

A

Aldosterone analogue

27
Q

Example of an Aldosterone analogue

A

Fludrocortisone

28
Q

Example of a Synthetic glucocorticoid with no mineralocorticoid activity

A

Dexamethasone

29
Q

Example of a Glucocorticoid with weak mineralocorticoid activity

A

Prednisolone

30
Q

Example of a Glucocorticoid with mineralocorticoid activity at high doses

A

Hydrocortisone

31
Q

RoA of corticosteroids?

A

oral and parenteral

32
Q

4 examples of corticosteroids?

A

Hydrocortisone, prednisolone, dexamethasone and fludrocortisone

33
Q

Longest acting corticosteroid?

A

Dexamethasone

34
Q

What disease is primary adrenocortical failure known as

A

ADDISON’S DISEASE

35
Q

What is Secondary adrenocortical failure

A

ACTH deficiency

36
Q

What is acute adrenocortical failure

A

ADDISONIAN CRISIS

37
Q

What is congenital adrenal hyperplasia

A

CONGENITAL LACK OF ENZYMES NEEDED FOR ADRENAL STEROID SYNTHESIS

38
Q

What is lacking in primary adrenocortical failure

A

lack cortisol and aldosterone

39
Q

What is lacking in secondary adrenocortical failure

A

ACTH deficiency so Patients lack cortisol but aldosterone is normal

40
Q

What is lacking in Congenital adrenal hyperplasia

A

CONGENITAL LACK OF ENZYMES NEEDED FOR ADRENAL STEROID SYNTHESIS and so lacking cortisol and aldosterone and sex steroids

41
Q

Treatment for Primary adrenocortical failure

A

: hydrocortisone (larger dose in morning, as this mimics normal physiology) and fludrocortisone (both orally)

42
Q

Treatment for secondary adrenocortical failure

A

hydrocortisone

43
Q

Treatment for acute adrenocortical failure

A

i.v. 0.9% sodium chloride (to rehydrate patient), high dose hydrocortisone (i.v. infusion or i.m.- every 6 hours Mineralocorticoid effect at high dose (11b-HSD overwhelmed)), 5% dextrose if hypoglycaemic

44
Q

If someone is on glucocorticoid medication, what times do you need to increase their dose during life

A

During the morning should take higher dose
in minor illness
and surgery

45
Q

What is Iatrogenic Adrenocortical Failure

A

in patients on long‐term, high dose corticosteroid treatment
If they are on glucocorticoids for a long time, this can suppress adrenal function because they don’t have to produce cortisol themselves anymore -­‐ they have a suppressed HPA axis
These patients also need to increase their dose when they experience a stress

46
Q

What patients experience Iatrogenic Adrenocortical Failure

A

in patients on long‐term, high dose corticosteroid treatment

47
Q

What does ACTH stimulate

A

Cortisol AND sex steroids

48
Q

What three things trigger aldosterone

A

Hyperkalaemia ‐ because aldosterone increases urinary potassium
excretion
Hyponatraemia
Drop in Renal Blood Flow - juxtaglomerular apparatus detects a drop in renal blood flow and releases renin

49
Q

What is synthetic cortisol known as

A

Hydrocortisone

50
Q

What protein binds glucocorticoids in blood

A

Corticosteroid binding globulin and albumin

51
Q

Difference in hormones of primary vs secondary adrenocortical failure

A

Aldosterone is normal in secondary as it is only ACTH that is deficient

52
Q

First step in an addisonian crisis?

A

You need to replace the lost salt, restore circulating volume and improve
the blood pressure before proceeding

Endocrinology Y2 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions