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128 - Gen Endocrine > Adrenal > Flashcards

Flashcards in Adrenal Deck (15):
1

What does the Adrenal gland do?

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2

What is the control mechanism for the minerocorticoid from the Zone Glomerulosa, Aldosterone?

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3

What is the function of Aldosterone?

It increased water levels by increasing sodium absoption in exchange the K in the kidney.

This increased blood pressure

4

What is the control mechanism for the glucocorticoid from the Zona fasciculata, Cortisol?

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5

What does cortisol do?

It decreased the immune response and wound healing

It increased blood sugar

6

What does the Zone reticularis do?

It releases androgens but the control mechanism is unknown

7

What does the adrenal medulla do?

Released adrenaline

8

Summarise steroidagenesis

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9

What are the symptoms, pathology, investigations and treatment of a phaeochromocytoma?

 

Symptoms - Headache, tachycardia, sweating

Pathology - Tumour of the adrenal medulla

Investigations - Increased 24 hr urine catecholamines Investigate futher via MRI 

Treatment - Surgery

Medical Treament - B blockers plus low sodium diet to counteract high BP

 

10

What are the symptoms, pathologies and treatments of Cushings disease and cushings Syndrome?

 

Symptoms - Poor wound healing

Central obesity

Straie/brusing from thin skin and dilated vessels

Buffal hump

Moon face

Depression, fatigue

Hirsutism

Cushings - Increased ACTH and cortisol

Cushings Disease - ACTH producing tumour in pituatry

Cushings Syndrome - Ectopic ACTH production

All of these result in an increased cortisol level and the symptoms mentioned.

Treatment - Surgery or metyrpone. This blocks 11b hydroxylase which makes cortisol

11

How do you differentiate between Cushings disease and Cushings Syndrome?

Dexamethasone test.

Low dose and low ACTH means its not cushings as levels are falling as normal.

High dose and low ACTH means cushings disease

High dise and no fall in ACTH means ectopic

12

What are the symtoms, investigations, pathology and treatments of Conns Syndrome?

 

Pathology - Increased aldosterone causing increased NA and water retention and hypertension

 

Symptoms - Hypertension, hypernaetremia, hypokaleamia

Investigations - High aldosterone but low renin

high NA, Low K, hypertension

 

Treatment - Low Na diet/surgery

13

What is the pathology, symptoms, investigations and treatment of Addisons. What is it associated with?

 

Pathology - This is adrenal insufficency usually caused by TB or AI.

Symptoms - Hypotension, hypoglycaemia, postural hypotension, hyperpigmentation, N+V, weight loss

Investigations - Hyponaetemia, hyperkalaemia, HIGH ACTH. If you give synctachen (Artificial ACTH) and there is no rise in cortisol, it is Addisons.

Treatment 

Hydrocortisone (glucocorticoid)

Fludrocortisone (Minerocorticoid)

14

What is congenital adrenal hyperplasia and what are the investigations?

A congenital disease with a lack of 21 hydroxylase. This is a key enzyme in the formation or minerocorticoids and glucocorticoids

 

Investigation - GIve synthetic ACTH and 17hydroxyprogesterone builds up but no 21 hydroxylase

15

What are the two types of CAH?

Salt Wasting - N+V, FTT, hyponaetremia. This is due to a decrease in corticoids.

Treat with hydrocortisone, fludrocortisone

Virilising - Clitoromegaly, hirsuitism, ambiguous genitalia. This comes about due to an increase in androgens as a result of a decrease in corticoids

Treat with oestragen, dexamethasone to suppress ACTH