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LCRS - Endo and Neuro > Lecture 11 - Adrenal disorders > Flashcards

Lecture 11 - Adrenal disorders Flashcards

1
Q

What is the main cause of endocrine disease?

A

Abnormal amounts of messenger present, causing cells to misbehave

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2
Q

What is the vascular anatomy of the adrenal glands?

A

Only one vein - left adrenal vein R adrenal vein drains into IVC

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3
Q

Where do the adrenal veins drain into?

A

LAV drains into renal vein and then into IVC RAV drains straight into IVC

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4
Q

Where is the spleen in relation to the adrenal glands?

A

Next to the LAG

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5
Q

Why is the location of the spleen important?

A

It can be easily damaged during a left adrenalectomy So patient must be immunised with HIB and pneumovax

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6
Q

What is HIB and pneumovax?

A

HIB= Haemophilius Influenzae type b Pneumovax= pneumococcal vaccination against several strains of Streptococcus pneumococcus

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7
Q

How do the hormones pass into the blood?

A

Arteries that pass through the cortex pick up all the hormones and then deliver it to the central vein

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8
Q

What are the different zones of the adrenal gland from outside to inside?

A

Glomerulosa - aldosterone Fasciculata - cortisol Reticularis - no real function Adrenal medulla - catecholamines (adrenaline/noradrenaline)

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9
Q

How are steroid hormones manufactured?

A

Precursor is CHOLESTEROL Remove the side chain and then add OH/oxidising the molecule to form many different molecules

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10
Q

What are the enzymes in steroid synthesis named after?

A

By the number of carbon that they affect

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11
Q

How is aldosterone produced from cholesterol?

A

Chol>pregnenolone>progesterone>(21) 11deoxy corticosterone>(11) corticosterone>(18) aldosterone

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12
Q

How is cortisol formed from cholesterol?

A

Chol>preg>progesterone>(17) 17OHprog>(21) 11 deoxycortisol>(11) cortisol

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13
Q

How is oestrogen formed from cholesterol?

A

Chol>preg>prog>(17) 17OHprog>sex steroid> androgens> oestrogens

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14
Q

How are the pathways for steroid hormone synthesis decided?

A

Depends on enzymes present in tissue

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15
Q

What is cortisol controlled by?

A

ACTH - cortisol is a stress hormone

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16
Q

What is the method of ACTH synthesis?

A

POMC> ACTH and MSH and endorphins

17
Q

What is MSH?

A

Melanocyte stimulating hormone - abnormal levels of ACTH can cause inappropriate tanning, as ^ MSH released

18
Q

What is the cause of Addison’s disease?

A

Failure in adrenal glands caused by: Autoimmune disease wiping out adrenal cortex TB of adrenal glands

19
Q

What is the most common cause of Addison’s in UK?

A

Autoimmune disease

20
Q

What is the most common cause of Addison’s worldwide?

A

TB of adrenal glands

21
Q

What are the main symptoms of Addison’s?

A

Darkening of skin in areas of pressure

Autoimmune vitiligo

Low BP - as no aldosterojne production

Weight loss, vomiting, diarrhoea

Muscular weakness

22
Q

What to do in an Addisonian crisis?

A

Rehydrate with saline Give dextrose to prevent hypoglycaemia Give hydrocrotisone

23
Q

What is addison’s?

A

Cortisol deficiency Salt loss Low BP Eventual death

24
Q

What are the biological actions of excess cortisol?

A

Diabetes - due to ^ BGL Weight gain - ^ fat, decreased protein Thin skin & easy bruising Striae Proximal myopathy Mental changes - depression Hypertension Fat redistribution Moon face Interscapular fat pad Hirsuitism and acne

25
Q

What are the causes of Cushing’s syndrome?

A

Steroids (oral intake) Pituitary adenoma (^ ACTH production) - Cushing’s DISEASE Ectopic ACTH - lung cancer cells can produce ACTH Adrenal carcinoma/adenoma

26
Q

What are the clinical signs of Cushing’s syndrome?

A

LEMON ON STICKS - centripetal obesity

Proximal myopathy, Thin skin

Diabetes, hypertension, osteoporosis

Immunosuppression

Moon face

27
Q

What is the difference between CS and CD?

A

CS= collection of symptoms with any cause CD=cause is pituitary adenoma

28
Q

What are the side effects of steroids?

A

Similar to Cushing’s syndrome: Hypertension, diabetes, osteoporosis, immunosuppresion, easy bruising, poor wound healing, thin skin

29
Q

What is Conn’s syndrome?

A

Aldosterone producing adenoma Tumour of zona glomerulosa

30
Q

What are the symptoms of Conn’s syndrome?

A

Aldosterone causes retention of Na and loss of K Hypertension Oedema Low blood K

31
Q

What is the hypothalamo pituitary axis?

A
32
Q

How are the different steroid hormones produced? (simple version)

A

LCRS - Endo and Neuro (22 decks)

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