Adrenal

Question 1

what does the zona glomerulosa produce?

Answer 1

mineralocorticoids and aldosterone

Question 2

what does the zona fasciculata produce?

Answer 2

glucocorticoids and cortisol

Question 3

what does the zona reticularis produce?

Answer 3

sex steroids and glucocorticoids

Question 4

what do the neuroendocrine (chromaffin) cells of the medulla secrete

Answer 4

catecholamines

Question 5

what are the causes of hyper function?

Answer 5

hyperplasia, adenoma, carcinoma

Question 6

what are the causes of hypo function?

Answer 6

acute: waterhouse-Friderichsen
Chronic: Addisons

Question 7

what is congenital adrenocortical hyperplasia?

Answer 7

group of autosomal recessive disorders, lack of enzyme required for steroid biosynthesis

Question 8

what is acquired adrenocortical hyperplasia?

Answer 8

endogenous ACTH production

Question 9

what is Conns syndrome?

Answer 9

primary hyperaldosteronism

Question 10

what happens in secondary hyperaldosteronism?

Answer 10

increase in renin

Question 11

where can you see pigmentation in Addisons disease?

Answer 11

buccal mucosa and palmar surfaces

Question 12

what are the two adrenal medullary tumours?

Answer 12

phaeochromocytoma and neuroblastoma

Question 13

what is Phaeochromocytoma?

Answer 13

neoplasm derived from chromaffin cells of the adrenal medulla, secretes catecholamines

Question 14

what are the nests of tumour cells called in phaeochromocytoma?

Answer 14

zellballen

Question 15

Phaeochromocytoma is a feature of?

Answer 15

MEN = multiple endocrine neoplasia

Question 16

what syndrome is otherwise known as MEN(2A)

Answer 16

sipple syndrome

Question 17

what makes up Sipple syndrome?

Answer 17

Phaeochromocytoma, medullary thyroid carcinoma, parathyroid hyperplasia

Question 18

what genetic abnormality is Sipple syndrome linked to?

Answer 18

RET oncogene

Question 19

what makes up MEN(2B)

Answer 19

phaeochromocytoma, medullary thyroid carcinoma, neuromas/ganglioneuromas and marfanoid habitus

Question 20

what is a synacthen test?

Answer 20

synthetic ACTH

Question 21

what is the result of a normal synacthen test?

Answer 21

over 550

Question 22

what are the layers of the adrenal gland from lateral to medial

Answer 22

ZG, ZF, ZR and medulla

Question 23

what compound is the starting point in the biosynthesis of corticosteriods?

Answer 23

cholesterol

Question 24

what is the rate limiting step in the biosynthesis of corticosteroids?

Answer 24

conversion of cholesterol to pregnenlone

Question 25

what is aldosterone regulated by?

Answer 25

renin-angiotensin system and plasma potassium

Question 26

when is cortisol at its peak?

Answer 26

8/9am

Question 27

effect of cortisol on the circulatory/renal system?

Answer 27

increase cardiac output, increase BP and increase blood flow

Question 28

effect of cortisol on the CNS

Answer 28

mood, decrease libido

Question 29

effect of cortisol on the bone

Answer 29

accelerate osteoporosis, decrease calcium/collagen formation/wound healing

Question 30

effect of cortisol on the metabolic system?

Answer 30

increase in food stuff breakdown

Question 31

what receptor does aldosterone work on?

Answer 31

mineralocorticoid receptor

Question 32

what are the effect on NA and K in addisons?

Answer 32

decreased NA, increase K

Question 33

what do we give as cortisol replacement?

Answer 33

Hydrocortisone

Question 34

what do we give as aldosterone replacement?

Answer 34

Fludrocortisone

Question 35

what kind of structures are the adrenal glands?

Answer 35

retroperitoneal

Question 36

what hormones are secreted from the medulla?

Answer 36

adrenaline and nor-adrenaline

Question 37

if the Aldosterone to Renin ratio is over 750 what do we do?

Answer 37

saline suppression test

Question 38

what is a plethoric complexion or 'moon face'?

Answer 38

redistribution of fat around the body in cushings

Question 39

what are paraganglia cells?

Answer 39

collections of adrenaline secreting chromaffin cells

Question 40

what is Phaeochromocytoma caused by?

Answer 40

catecholamine secreting tumours which arise from sympathetic paraganglia cells