Adrenal - Basic Science & Hyperfunction Flashcards Preview

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Flashcards in Adrenal - Basic Science & Hyperfunction Deck (56)
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1

What 3 things are produced in the adrenal cortex?

Glucocorticoids, mineralocorticoids and androgens

2

What is the main glucocorticoid hormone produced by the adrenal cortex?

Cortisol

3

What is the main mineralocorticoid hormone produced by the adrenal cortex?

Aldosterone

4

What type of cells are found in the adrenal medulla?

Chromaffin cells

5

What is produced by the adrenal medulla? Give two examples.

Catecholamines e.g. adrenaline and noradrenaline

6

The synthesis of all the corticosteroids in the adrenal cortex begins with what?

Cholesterol

7

Which type of steroid hormone is produced in the zona glomerulosa of the adrenal cortex?

Mineralocorticoids

8

What regulates mineralocorticoid activity?

Angiotensin II (RAAS) and K+ level

9

Which type of steroid hormone is produced in the zona fasciculata of the adrenal cortex?

Glucocorticoids

10

Which type of steroid hormone is produced in the zona reticularis of the adrenal cortex?

Androgens

11

What regulates glucocorticoid activity?

ACTH

12

What regulates androgen activity?

ACTH

13

What hormone is released from the hypothalamus in the hypothalamic-pituitary-adrenal axis?

Corticotropin releasing hormone

14

What hormone is released from the pituitary gland in the hypothalamic-pituitary-adrenal axis?

ACTH

15

RAAS is a major regulator of aldosterone production. It is activated in response to what?

Decreased blood pressure

16

What is the effect of aldosterone?

Increase sodium reabsorption, and increase hydrogen and potassium excretion

17

Are corticosteroid receptors intra or extracellular?

Intracellular

18

What is the name for the clinical state of chronic glucocorticoid excess?

Cushing's syndrome

19

When is cortisol usually at its highest and lowest levels in the normal circadian rhythm?

Usually lowest at midnight and highest upon waking

20

What is the most common cause of Cushing's syndrome?

Use of oral steroids

21

What is the most common endogenous cause of Cushing's syndrome?

Cushing's disease (ACTH secreting pituitary adenoma)

22

What are the two main ACTH dependent (high ACTH) causes of Cushing's syndrome?

Cushing's disease and ectopic ACTH production

23

What are the two main ACTH independent (low ACTH) causes of Cushing's syndrome?

Adrenal pathology (adenoma/hyperplasia) and iatrogenic steroid use

24

What effect does Cushing's syndrome have on blood pressure?

Hypertension

25

What effect does Cushing's syndrome have on blood glucose levels?

Hyperglycaemia

26

If individuals with Cushing's syndrome have an acid-base disorder, what is this most likely to be?

Hypokalaemic metabolic alkalosis

27

What is the first line screening test for Cushing's syndrome?

Overnight dexamethasone suppression test

28

In the overnight dexamethasone suppression test, 1mg of dexamethasone is given at midnight and a cortisol level is taken at 8am. If the individual has Cushing's syndrome, the cortisol level will be greater than what?

50nmol/L

29

If an overnight dexamethasone suppression test is not suitable, what is another screening test that can be used for Cushing's syndrome?

24h urinary free cortisol

30

A normal 24h urinary free cortisol would be less than what value?

280nmol/L