adrenal

Question 1

Adrenal glands are also called

Answer 1

suprarenal

Question 2

adrenal medulla is connected directly to the SNS via

Answer 2

nerves

Question 3

the adrenal medulla releases

Answer 3

catcholamines

Question 4

T/F Catecholamines are made by chromaffin cells in the adrenal medulla

Answer 4

TRUE

Question 5

catecholamines are all derived from

Answer 5

tyrosine

Question 6

what are the 4 catecholamines

Answer 6

DOPA, dopamine, norepinephrine, epi

Question 7

what is the principal product of the adrenal medulla

Answer 7

epi

Question 8

T/F Epi is made only in the adrenal medulla

Answer 8

TRUE

Question 9

Epi accounts for nearly ___of the adrenal medulla’s output, the other ___ is norepinephrine, and a scant amt of ___ is also made here

Answer 9

80%, 30, dopamine

Question 10

fight or flight - decreased blood flow to ___, ___ and ____

Answer 10

kidneys, skin, mucosa

Question 11

epi and norepinephrine both have strong ____ effects which result in arterial vasoconstriction

Answer 11

alpha-1

Question 12

epi has stronger ____ which increases HR and contractility more

Answer 12

beta1

Question 13

___ is an enzyme necessary for conversion of norepinephrine to epi

Answer 13

PNMT

Question 14

T/F: PNMT is regulated by serotonin

Answer 14

False - regulated by glucocorticoids (cortisone)

Question 15

T/F: Pheochromocytoma is a tumor caused by adrenal medullary hyperplasia or extra-adrenal chromaffin tissue

Answer 15

TRUE

Question 16

s/s of Pheochromocytoma

Answer 16

paroxysmal htn, tachycardia, HA, sweating, anxiety, tumor, glucose intolerance

Question 17

Most tumors (85-90%) are solitary tumors localized to a single adrenal gland (mostly the ____)

Answer 17

right

Question 18

__ of tumors are extra-medullary, of these __ are in the abdomen

Answer 18

10. 95

Question 19

____ levels help to make the diagnosis of Pheochromocytoma as both epi and norepinephrine are degrade to this

Answer 19

Urinary VMA

Question 20

___blockers com before ___ blockers for surgery in pt with Pheochromocytoma

Answer 20

alpha, beta

Question 21

start a-blockers ___ days prior to surgery

Answer 21

10-14

Question 22

why is beta blockade delayed?

Answer 22

the risk of unopposed alpha mediated vasoconstriction

Question 23

Pheochromocytoma use ___ acting vasoactive agents

Answer 23

short-acting

Question 24

which drugs release histamine and provoke Pheochromocytoma

Answer 24

reglan and glucagon

Question 25

T/F Catecholamine levels return to normal several days after surgery and approx ___% of patients become normotensive within __ days post-op

Answer 25

75, 10

Question 26

T/F the physiologic effect of medullary hypo secretion is not a serious problem

Answer 26

TRue

Question 27

adrenal cortex produces ___ and ____ and is a secondary site of ___ synthesis

Answer 27

mineralocorticoids , glucocorticoids, androgen

Question 28

the zona glomerulosa produces ____

Answer 28

mineralocorticoids

Question 29

the zona fasciculata produces ____

Answer 29

glucocorticoids

Question 30

zona reticulatis produces ____

Answer 30

androgens

Question 31

what is the primary mineralcorticoid

Answer 31

aldosterone

Question 32

what is the primary glucocorticoid

Answer 32

cortisol

Question 33

what is the primary androgen

Answer 33

aldosterone

Question 34

T/F all of the hormones of the adrenal cortex are steroid hormones, all are synthesized from cholesterol

Answer 34

TRUE

Question 35

aldosterone causes retention of ___ and excretion of ____

Answer 35

retention of sodium and water, excretion of K and H+

Question 36

T/F if unopposed, aldosterone leads to hypertension, ECF expansion, hyperkalemia, and acidosis

Answer 36

FALSE - hypokalemia and alkalosis

Question 37

T/F ACTH and Na levels don not exert much control over the release of aldosterone

Answer 37

TRUE

Question 38

Conn's syndrome is a form of ___ hyperaldosteronism which causes ___ ECF Volume, ___tension, K+ ____ and what acid base disturbance?

Answer 38

``` Conns: primary hyperaldo increased ECF volume htn K+ depletion metabolic alkalosis ```

Question 39

what causes conn's

Answer 39

aldosterone secreting tumors or hyperplasias

Question 40

T/F Secondary hyperaldosteronism is caused by CHF, cirrhosis with ascites, and nephrosis

Answer 40

TRUE (ECF lost to extravascular space)

Question 41

hypoaldosteronism is caused by ____. __ is lost in the urine and __ is retained.

Answer 41

adrenal insufficiency na k

Question 42

hypoaldosteronism- plasma volume ___ and hypotension/hyper___ may lead to circulatory collapse

Answer 42

decreases, hyperkalemia

Question 43

T/F muscles can become weak in great cortisol deficiency

Answer 43

FALSE - cortisol excesses

Question 44

___ levels of cortisol have anti-inflammatory effects

Answer 44

high

Question 45

ACTH release is controlled by ___ from the hypothalamus

Answer 45

CRH

Question 46

T/F High Cortisol levels cause inhibition of ___ and ___ release

Answer 46

ACTH , CRH

Question 47

cortisol is a ___ feedback system

Answer 47

negative

Question 48

Cushing disease vs syndrome

Answer 48

dz: ACTH secreting tumor of the pituitary syndrome: excessive cortisol secretion

Question 49

T/F: Addison's dz results from failure to produce adrenocortical hormones

Answer 49

TRUE

Question 50

T/F etomidate causes profound suppression of cortisol for at least 24h and can contribute to adrenal insufficiency and resultant hypotension

Answer 50

TRUE

Question 51

T/F etomidate causes profound suppression of cortisol for at least 24h and can contribute to adrenal insufficiency and resultant hypotension

Answer 51

TRUE

Question 52

T/F Etomidate should be used sparingly in patients with septic shock

Answer 52

TRUE