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Clin Med 2 > Test Your Knowledge 4 > Flashcards

Test Your Knowledge 4 Flashcards

1
Q

Where are the adrenal glands located?

A

On top of the kidneys

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2
Q

What are the two parts of the adrenals?

A
  • adrenal cortex

- adrenal medulla

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3
Q

What is the adrenal cortex stimulated by?

A

ACTH

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4
Q

What is the adrenal medulla stimulated by?

A

Sympathetic nervous system

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5
Q

Why are epi and norepi considered hormones and NTs?

A

adrenal medulla has connections to both the bloodstream and the nervous system

  • connection to the bloodstream allows it to act as a hormone
  • connection to nervous system allows it to act as a NT
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6
Q

When acting as a hormone via the bloodstream, epi/norepi are (fast/slow) acting

A

Slow

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7
Q

When acting as a NT via the nervous system, epi and norepi are (fast/slow) acting

A

Fast (think fight or flight)

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8
Q

What are the categories of effects/roles of cortisol?

A
  • metabolic
  • anti-inflammatory
  • growth suppression
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9
Q

Metabolic effects of cortisol

A
  • stimulates protein catabolism

- stimulates glucose anabolism

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10
Q

Cortisol: glucose anabolism can lead to

A

Increased fat deposition in

  • abs
  • cheeks
  • supraclavicular region
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11
Q

Cortisol: anti-inflammatory effects

A
  • decreases T-cell formation and function
  • Suppresses macrophages
  • Stabilizes lysosomes
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12
Q

What may the anti-inflammatory effects of cortisol lead to?

A

Poor wound healing

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13
Q

Role of lysosomes in inflammation

A

Lysosomes are potent immune suppressants

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14
Q

Cortisol: role in growth suppression

A

Inhibits bone formation » osteoporosis

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15
Q

Aldosterone plays a large role in

A
  • RAAS/RAS

- Inhibition of renal reabsorption of potassium

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16
Q

RAAS =

A

Renin-angiotensin-aldosterone system

17
Q

What does the RAAS do?

A

Regulates BP by conserving sodium, which would increase BP

18
Q

What stimulate the RAAS to kick in?

A

Low BP

19
Q

Primary adrenal insufficiency is called

A

Addison disease

20
Q

Clinical manifestations of Addison disease

A
  • Dark pigmentation of the skin to varying degrees
  • Hypotension
  • Fatigue (progressive)
  • Hyperkalemia
  • GI disturbances
  • Arthralgias with secondary myalgias
  • Tendon calcification
  • Hypoglycemia
21
Q

Addison disease: dark pigmentation

A
  • freckles
  • healthy glowing tan
  • darkening around mouth
  • scars
22
Q

Addison disease: fatigue

A
  • progressive

- improves with rest

23
Q

Addison disease: GI disturbances

A
  • anorexia
  • WL
  • N/V
24
Q

What would an episode of adrenal crisis look like>

A
  • Severe abdominal pain
  • LBP
  • Leg pain
  • Severe vomiting and diarrhea
  • Hypotension
25
Q

Adrenal crisis episode: What could hypotension lead to?

A
  • hypovolemic shock

- MEDICAL EMERGENCY

26
Q

What is secondary adrenal insufficiency?

A
  • Dysfunction of the gland because there’s insufficient stimulation of cortex
  • due to lack of ACTH secreted by the pituitary
27
Q

What usually causes secondary adrenal insufficiency?

A
  • tumor of pituitary or hypothalamus
  • removal of pituitary
  • rapid withdrawal of corticosteroids
28
Q

What are some NM manifestations of secondary adrenal insufficiency?

A
  • Myalgia
  • Arthralgias
  • Tendon calcification
  • NOT associated with hyperpigmentation
29
Q

Hyperfunction of the adrenal gland, resulting in increased cortisol is called

A

Cushing syndrome

30
Q

Why will we most often see pts related to increased serum cortisol?

A

Many of our pts will be on corticosteriod meds

31
Q

What happens to the adrenals (anatomically) with increased serum cortisol?

A
  • adrenals atrophy

- pituitary stops secreting ACTH

32
Q

Why should steroids not be stopped abruptly?

A
  • atrophied gland will not be able to provide cortisol necessary for physiologic needs
  • can result in acute adrenal insufficiency, which requires emergency cortisol replacement
33
Q

What are the clinical manifestations of Cushing Syndrome?

A
  • moon face
  • buffalo hump
  • abd protrusion with stretch marks
  • muscle wasting
  • decreased bone density
  • hypertension
  • kyphosis
  • bruising
  • emotionally labile
  • impaired reproduction
  • diabetes
  • slow wound healing
  • masculinizing
34
Q

What is the medical mgmt for Cushing syndrome?

A
  • Restore hormone balance

- Lifelong glucocorticoid replacement necessary when pituitary is removed or destroyed

35
Q

What is used to restore hormone balance with Cushing syndrome?

A
  • pituitary irradiation
  • drug therapy
  • surgery (adrenalectomy)

Clin Med 2 (78 decks)

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