5: Adrenal gland disorders - physiology, Addison's, Cushing's, primary aldosteronism Flashcards Preview

Endocrine Week 4 2017/18 > 5: Adrenal gland disorders - physiology, Addison's, Cushing's, primary aldosteronism > Flashcards

Flashcards in 5: Adrenal gland disorders - physiology, Addison's, Cushing's, primary aldosteronism Deck (64)
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1

What are the two parts of the adrenal gland?

Adrenal cortex

Adrenal medulla

2

What are the three zones of the adrenal cortex?

Zona glomerulosa

Zona fasciculata

Zona reticularis

3

What hormone is produced in the zona glomerulosa of the adrenal cortex?

Mineralocorticoids

e.g aldosterone

4

What hormones are produced in the zona fasciculata of the adrenal cortex?

Glucocorticoids

cortisol

5

What hormones are produced in the zona reticularis of the adrenal cortex?

Androgens

6

Which cells, found in the adrenal medulla, secrete catecholamines?

Chromaffin cells

7

What is the precursor molecule for steroid hormones?

Cholesterol

8

Which axis regulates cortisol and androgen production by the adrenal cortex?

Hypothalamic-pituitary-adrenal axis

9

What regulates aldosterone secretion by the adrenal cortex?

Renin-angiotensin system

Which is regulated by blood pressure & renal perfusion

10

Corticosteroids bind to which kind of receptor?

Nuclear receptor

to alter transcription of protein

11

What are some

a) cardio

b) metabolic

c) bone and soft tissue

effects of cortisol?

a) Increased BP, cardiac output and renal perfusion

b) Increased blood glucose level, increased lipolysis and proteolysis, central redistribution of fat

c) Reduced serum calcium (inc. rate of onset of osteoporosis), reduced rate of wound healing

12

Cortisol (accelerates / dampens down) the immune response.

dampens down immune response

13

Which physiological processes are corticosteroids used to suppress?

Give examples of specific diseases.

Immune response

so allergic diseases like asthma, eczema and anaphylaxis

Inflammation

so inflammatory diseases like RA, UC and Crohn's disease

14

In which diseases are exogenous corticosteroids used as a replacement for a deficiency in the body?

Adrenal insufficiency

e.g Addison's disease (autoimmune reaction resulting in deficiency of cortisol), non-functioning adrenal tumours, non-functioning pituitary tumours

15

Aldosterone is a (glucocorticoid / mineralocorticoid) produced by the adrenal cortex.

What is its function?

mineralocorticoid

Stimulates Na+ reabsorption in the distal tubules and collecting ducts, therefore controlling sodium homeostasis and blood pressure via RAAS

16

What is the commonest cause of primary adrenal insufficiency?

Addison's disease

Also consider Congenital adrenal hyperplasia

17

Apart from Addison's disease, what else can cause primary adrenal insufficiency?

Congenital adrenal hyperplasia

TB

Malignancy

18

Adrenal insufficiency caused by a problem with the gland itself is (primary / secondary).

primary

19

Addison's disease is an ___ disease.

autoimmune

20

What is destroyed by autoimmune reaction in Addison's disease?

Adrenal cortex

21

70% of people with Addison's disease are positive for what?

Autoantibodies

22

People with Addison's disease are more likely to have other ___ diseases.

autoimmune

23

What are the features of Addison's disease?

Anorexia

Weight loss

Pigmentation

Dizziness and hypotension

Abdominal pain, vomiting, diarrhoea

24

What kind of pigmentation is common in people with Addison's disease?

Buccal pigmentation

25

What will be seen on biochemical tests of people with Addison's disease?

Hyponatraemia

Hyperkalaemia

Hypoglycaemia

26

Which stimulation test is used to diagnose adrenal insufficiency?

Synacthen test

27

In primary adrenal insufficiency, ACTH levels will be very (high / low).

high

causing skin pigmentation

28

In secondary adrenal insufficiency, what will the patient's ACTH be like?

Will they be pigmented?

Normal or low

No pigmentation

29

Why are aldosterone levels low in people with Addison's?

Destruction of adrenal cortex

30

How should Addison's disease be managed?

IV hydrocortisone (to replace cortisol)

Fludrocortisone (to replace aldosterone)