Adrenal Flashcards
(24 cards)
What is synthesised and released from the zona glomerulosa?
Aldosterone in response to angiotensin II & K+
What is synthesised and released from the zona fasiculata?
Glucorticoids (i.e. cortisol) in response to ACTH
What is synthesised and released from the zona reticularis?
Sex hormones in response to ACTH & CASH
What are the effects of cortisol?
Anti-inflammatory.
Stimulates gluconeogenesis > increased blood glucose.
Stimulates catabolism of proteins > increased blood AAs.
Stimulates FA release > increased blood FAs.
What is Cushing’s syndrome?
Elevated plasma [cortisol]
Name some causes of Cushing’s
Cushing’s disease - adenoma of the AP.
Adenoma of the adrenal cortex.
Abnormal hypothalamus function > elevated CRH release.
LT treatment with glucocorticoids.
What affect will primary cushings syndrome have on ACTH levels?
ACTH levels will be reduced.
What affect will secondary cushings have on ACTH levels?
ACTH levels will be elevated.
How can you differentiate between primary and secondary cushings?
Give dexamethasone - if ACTH levels fall = secondary cushings.
What are the symptoms of cushings?
Weight gain & central obesity. Moon faced. Plethoric. Easily bruised. Hypertension.
What is the treatment for cushings?
Removal of adenoma.
11-beta hydroxylase inhibitor (metyrapone) - blocks 11-B hydroxylase which is required for cortisol synthesis.
Mitotane.
What is 21-hydroxylase deficiency?
Most common cause of CAH.
Autosomal recessive disorder which leads to 21 hydroxylase deficiency - required for cortisol & aldosterone synthesis.
What are the symptoms of 21-hydroxylase deficiency?
Hypotension.
Hypovolaemia.
Salt wasting.
Sexual ambiguity and hirsuitism.
What will investigations for 21-hydroxylase deficiency show?
Elevated 17 hydroxyprogesterone levels.
Low cortisol levels.
Elevated androgen levels.
What is the treatment for 21-hydroxylase deficiency?
Hydrocortisone
Fludrocortisone
What is addisons disease?
Dysfunctioning adrenal gland > decreased cortisol & aldosterone synthesis.
What is the most common cause of addisons disease?
UK - autoimmune disease.
Worldwide - Tb.
What will primary addisons show?
Low aldosterone.
Elevated ACTH.
What will secondary addisons show?
Low aldosterone.
Low ACTH.
What are the symptoms of addisons?
skin pigmentation.
Weight loss, fatigue, fever & abdo symptoms.
Addisons crisis - hypotension > coma.
What is the treatment for addisons?
Hydrocortisone.
Fludrocortisone.
What is conns syndrome?
Hyperaldosteronism > hypertension.
What is pheochromocytoma?
Tumour of the adrenal medulla (chromaffin cells) or an extra-adrenal tumour > excess catacholamine release > hypertension.
What are the symptoms of pheochromocytoma?
Hypertension.
Episodes of sweating, palpitations and panic attacks
