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Endocrine > Adrenal conditions > Flashcards

Adrenal conditions Flashcards

1
Q

What is the name of the condition that is characterised by primary adrenal insufficiency

A

Addisons disease

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2
Q

What are the 3 types of hormones secreted from the adrenal cortex?

A
  1. mineralocorticoids
  2. glucocorticoids
  3. androgens
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3
Q

Give an example of a mineralocorticoid secreted from the adrenal cortex?

A

aldosterone

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4
Q

Give an example of a glucocorticoid secreted from the adrenal cortex?

A

Cortisol

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5
Q

What are the 5 physiological effects of cortisol on the body?

A
  1. Increases BP
  2. Immunosuppression
  3. Increases osteoclastic activity
  4. Metabolism
  5. Increases blood glucose levels
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6
Q

Describe the pathology that accounts for 70% of Addisons?

A

Auto antibodies that attack the adrenal cortex

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7
Q

What % of cases will about for autoimmune Addisons disease?

A

70%

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8
Q

True/False

Addisons disease is more common in men

A

FLASE

Addisons disease is more common in women

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9
Q

What is the name of the adrenal hormone secreted from the hypothalamus that acts on the pituitary?

A

Corticotrophin releasing factor

CRF

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10
Q

What is the name of the adrenal hormone that gets secreted from the Pituitary and acts on the adrenal cortex?

A

ACTH

Adrenocorticotrophic hormone

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11
Q

What feedback system controls hypothalamic pituitary axis?

A

Negative feedback

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12
Q

Whats is the name of the axis that controls the secretion of cortisol from the adrenal cortex?

A

Hypothalamic pituitary axis

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13
Q

What are the 3 T’s a patient with Addisons disease will present with?

A

Tanned
Tired
Tearful

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14
Q

What are the 5 symptoms that are a result from low glucocorticoids in Addisons disease?

A
  1. Generalised weakness
  2. tiredness
  3. Anorexia
  4. weight loss
  5. Pigmentations of the skin
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15
Q

What are the 2 symptoms that are a result from low androgens in Addisons disease?

A
  1. Less pubic and axillary hair

2. low libido

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16
Q

True/False

Patients with Addisons disease have primary hypertension?

A

False

Patients with Addisons disease have postural hypertension

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17
Q

What 2 blood pressure changes are visible in a patient with Addisons disease?

A

Lower BP

tachycardia

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18
Q

How might Addisons disease affect blood gluose levels?

A

Hypoglycaemia

Due to low levels of cortisol that is involved in increasing blood glucose levels.

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19
Q

What 4 GI disturbances will be seen on a patient with Addisons disease?

A
  1. Diarrhoea
    2 Vomiting
  2. Nausea
  3. Abdominal pain
20
Q

Why is a differential diagnosis for Addisons disease?

A

Thyroid disorders

21
Q

What are 3 blood result findings in Addisons?

A
  1. Hypokalaemia
  2. Hyponatremia
  3. Elevated urea
22
Q

Why must a CT scan be carried out when suspected of Addisons disease?

A

To check for tumours or enlargement of the adrenal glands

23
Q

Would ACTH levels be high or low in Addisons disease?

A

High

24
Q

The presence of ? should always be checked for in Addisons disease

A

Auto-antibodies

25
Q

What is the name of the glucocorticoid replacement therapy for Addisons disease?

A

Hydrocortisone

26
Q

What is the name of the mineralocorticoid used for treating Addisons disease?

A

Fludrocortisone

27
Q

What is responsible for the secretion of GH?

A

Anterior pituitary

28
Q

What is acromegaly characterised by?

A

Prolonged exposure and increased secretion of GH

29
Q

What aetiology accounts for 99% of acromegaly cases?

A

Adrenal or pituitary tumours and hyperplasia

30
Q

Which type of cancers can also cause release of GH/GHRH and result in acromegaly?

A

Lung and pancreatic cancers

31
Q

What cause the presentation of clinical features seen in acromegaly?

A

Prolonged and excess GH exposure that results in somatic and metabolic effects

32
Q

What is hyperhidrosis seen in acromegaly?

A

Increased sweating

33
Q

What is Bitemporal Hemianopia seen in acromegaly?

A

Its the loss of vision in the outer half of the eyes

34
Q

What causes bitemporal hemianopia?

A

Compression of the optic chiasm from a significant pituitary adenoma

35
Q

What complication is present in 40% of acromegaly patients?

A

Impaired glucose tolerance

T2DM

36
Q

Name 4 cardiovascular complications that can arise as a result of acromegaly?

A
  1. Arrhythmia
  2. hypertension
  3. LV hypertrophy
  4. cardiomyopathy
37
Q

What is the primary blood investigation for acromegaly?

A

IGF-1
insulin-like growth factor-1

reflect GH secretion and correlates with features of acromegaly

38
Q

What is 1st line treatment for acromegaly?

A

Transphenodial surgery

39
Q

What does Transphenodial surgery involve?

A

Removal of the tumours on the pituitary gland

40
Q

What is another name for somatostatin?

A

Growth hormone inhibiting hormone

41
Q

Name a somatostatin analogue that can be used as 2nd line to treat acromegaly?

A

Octreoide

42
Q

Name a dopamine agonist that can be used to treat acromegaly?

A

Bromocripitine

43
Q

What is 3rd line treatment in treating acromegaly?

A

Radiotherapy

44
Q

What 3 structures secrete somatostatin?

A
  1. brain
  2. GI tract
  3. pancrease
45
Q

Which hormone is more potent in inhibiting GH release?

somatostatin
dopamine

A

Somatostatin

Endocrine (9 decks)

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