Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrinology > Adrenal > Flashcards

Adrenal Flashcards

(69 cards)

Start Studying
1
Q

What are the layers of the adrenal gland?

A 
(superficial) 
capsule
cortex
medulla
(deep)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three zones of the cortex? What do they secrete?

A

Zona glomerulosa-mineralocorticoids
Zona fasciculata- glucocorticoids
Zona reticularis- adrenal androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is contained in the adrenal medulla? What is secreted?

A

chromaffin cells secrete catecholamines, medullary veins, splanchnic (sympthetic) nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the corticosteroids made from in the adrenal cortex?

A

cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Whatis the end corticosteroid from

a) z. glomerulosa
b) z fasciculata
c) z. reticularis

A

a) aldosterone
b) cortisol
c) DHEA and androstendione

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q 
How is the production of
a) aldosterone
b) cortisol
c) androgen
regulated?
A

a) RAAS and plasma K+
b) hypothalamus and ant. pit.
c) hypothalamus and ant. pit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the cortisol/androgen axis?

A

Hyp: CRH+
Pit: ACTH+
Adrenal cortex:Cortisol

NB, negative feedback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does the RAAS system work?

A 
Fall in BP
Renin released from kidneys
Turns angiotensinogen to angiotensin 1
ACE turn it to angiotensin 2
(vasoconstriction=direct)
Angiotensin 2 causes aldosterone to be released from adrenal
Aldosterone increases salt retention (indirect)
BP rises
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the mechinism of action in corticosteroids?

A

Steroid hormones binds to intracellular receptor

DNA is bound to affect transcription

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the metabolic affect of cortisol?

A

increase blood sugar
increased lipolysis (central distribution)
increased proteolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the CVS effects of cortisol?

A

Increased CO
Increased BP
increased renal blood flow and GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the MSK effects of cortisol?

A

accelerates osteoporosis
reduced serum Ca2+
reduced collagen
reduced wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the immunological effects of cortisol?

A

reduced capillary permeabilty
reduced leukocytes
reduced macrophages
reduced cytokines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the main uses of corticosteroids?

A

suppress inflammation
suppress immune system
replacement treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where are Mineralocorticoid receptors found?

A

kidneys
salivary glands
gut
sweat glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the effects of aldosterone?

A

K+/H+ excretion
increased Na+ reabsorption
BP regulation
Regulates ECF volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can cause adrenal insuffieciency?

A

Inadequate adrenal function
Primary insufficiency
Secondary insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are causes of primary adrenal insufficiency?

A

Addison’s
Congenital adrenal hyperplasia
Adrenal TB
Malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can cause secondary adrenal insufficiency?

A

lack of ACTH stimmulation
iatrogenic steroids
Pituitary/Hypothalamic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the commonest cause of primary adrenal insufficiency?

A

Addison’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the aetiology of addison’s?

A

Autoimmune destruction of adrenal cortex
Autoantibodies in 70%
Low cortisol levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How much of the adrenal will be destroyed before symptoms of addison’s appear?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

With what other conditions is addison’s associated?

A

T1DM
Pernicious anaemia
Autoimmune thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the symptoms of addison’s?

A 
Anorexia
Weight loss
Fatigue
Dizziness
Low BP
Abdo pain
Vomiting
Diarrhoea
Skin pigmentation (ACTH)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the diagnositic features of addison's?
``` low Na+ high K+ Anbormal synacthen Hypoglycaemia Increased ACTH increased renin/reduced alsdosterone Adrenal sutoantibodies ```
26
What dynamic test would be used to test for addison's? How does it work?
Short SynATCHen test - measure before and 30 mins after iv ACTH injection - before >250nmol, after>480 is normal
27
What is the management for addison's?
Hydrocortisone to replace cortisol( IV if unwell, 15-30mg daily, mimic diuinal rhythm) Fludrocortisone to replace aldosterone (monitor BP and K)
28
What education do patients treated for adrenal insufficiency need?
sick day rules do not stop suddenly wear identification
29
How is secondary adrenal insufficiency characterised?
lack of CRH or ACTH
30
What is the most common cause of secondary adrenal insufficiency?
exogenous steroids | mimcs negative feedback
31
How is secondary adrenal insufficiency different to addison's?
``` Pale skin (no inc ACTH) Aldosterone intact (no RAAS involvement) ```
32
How is secondary adrenal insufficiency treated?
``` Hyrdocortisone only (no need for fludrocortisone) ```
33
How is cushing's syndrome defined?
excess cortisol secretion
34
what is the etiology of cushing's?
women | 20-40years
35
What are the symptoms of cushing's?
easy bruising striae facial plethora proximal muscle weakness
36
What are the adrenal causes of cushing's?
adrenal adenoma/carcinoma
37
What is the most common cause of Cushing's?
iatrogenic high dose steroids=chronic suppression of ATCH and adrenal atrophy
38
What is primary aldosteronism?
Autonomus production of aldosterone independent of regulators(angiotensin 2/K)
39
What are the CVS actions of aldosterone?
``` increased cardiac collagen increased sympathetics Na+ retention Cytokine synthesis Altered endothelial function ```
40
What are the CVS responses to aldosterone?
inc BP - LVH - Atheroma
41
What are the clinical features of primary aldosteronism?
Significant hypertension Hypokalaemia Alkalosis
42
What are the causes of primary aldosteronism?
``` adrenal adenoma (Conn's syndrome) Bilateral hyperplasia (commonest) Genetic mutation (KCNJ5 channel) Unilateral hyperplasia(rare) ```
43
How is primary aldosteronism diagnosed?
1) -measure ARR (aldosterone renin ratio) - >750 then saline suppression test - failure to suppress saline by 50%=PA 2) confirm subtype - Adrenal CT - adrenal vein sample to confirm adenoma s true source
44
How is primary aldosteronism managed?
Surgical laproscopic adrenalectomy if adenoma. | Spironolactone if bilateral hyperplasia (MR antagonist)
45
What is congenital adrenal hyperplasia?
defect with enzymes in steroid pathway
46
What is the most common enzyme deficiency in CAH?
21a hydroxylase
47
How is CAH diagnosed?
Basal/stimulated 17-OH progesterone levels
48
How do males with CAH classically present?
Adrenal insufficiency (2-3 weeks) poor weight gain Addison's biochemical pattern
49
How do females with CAH classically present?
genital ambiguity
50
What is the non-classical presentation of CAH?
``` Hirsuites Acne Oligomaenhorroea Precocious puberty Infertility/subfertility ```
51
What is the principles of treatment of CAH in children?
Timely recognition Gluco/mineralocorticoid replacement surgical correction Acheive maximum growth potential
52
What are the principles of treatment in CAH adults?
Control androgen excess Restore fertility Avoid steroid overreplacement
53
What is the weight of an adrenal gland in healthy adults?
4g
54
What is phaeochromocytoma?
rare tumour of adrenal medulla Increased catecholamines 10% tumour
55
Why do adrenals look brown in phaeochromocytoma?
chromaffin cells reduce chrome salts to metal chromium
56
Why is it important to diagnose phaeochromocytoma?
Curable hypertension surgical risks pregnancy risks potentially fatal
57
What are the symptoms of phaeochromocytoma?
``` Triad: hypertension (50%paroxysmal), headache, sweating palpitations breathless constipation anxiety weight loss ```
58
What are the signs of phaeochromocytoma?
``` hypertension postrual hypotension (50%) pallor arrythmia pyrexia ```
59
What are the biochemical abnormalities in phaeochromocytoma?
``` hyperglycaemia low K raised Hb mild hypercalcaemia lactic acidosis ```
60
Who should be investigated for phaeochromocytoma?
family memebers with syndromes resistant hypertension <50 yrs patient with HT HT and Hyperglycaemia
61
How can phaeochromocytoma be confirmed?
confirm catecholamine excess | Urine catecholamine samples 2x24hr
62
How can you identify the source of catecholamine excess in phaeochromocytoma?
MRI PET MIBG scans
63
How is phaeochromocytoma treated?
alpha and beta blockade fluid+/- blood replacement total excision where possible chemotherapy if malignant
64
What conditions are associated with phaeochromocytoma?
Multiple endocrine neoplasia 2 Succinate dehydrogenase mutations Neurofibromatosis Tuberose sclerosis
65
What is MEN2?
Autosomal dominant mutation of tyrosine kinase receptor associated:MTC, parathyroid hyperplasia, bilateral phaeochromocytoma
66
What is Von Hippel Lindau syndrome?
Mutation HIF1-a Autosomal dominant Vascular tumour SDH genes stabilise HIF1-a
67
What are the signs of neurofibromatosis?
Axillary freckling Cafe au lait patches Neurofibromas
68
What is the apperance of phaeochromocytoma?
Zellballen (cells form nests)
69
Where do phaeochromocytomas metastasise to?
bones regional lymph nodes liver lung

Endocrinology (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions