Adrenal conditions

Question 1

What is the name of the condition that is characterised by primary adrenal insufficiency

Answer 1

Addisons disease

Question 2

What are the 3 types of hormones secreted from the adrenal cortex?

Answer 2

1. mineralocorticoids
2. glucocorticoids
3. androgens

Question 3

Give an example of a mineralocorticoid secreted from the adrenal cortex?

Answer 3

aldosterone

Question 4

Give an example of a glucocorticoid secreted from the adrenal cortex?

Answer 4

Cortisol

Question 5

What are the 5 physiological effects of cortisol on the body?

Answer 5

1. Increases BP
2. Immunosuppression
3. Increases osteoclastic activity
4. Metabolism
5. Increases blood glucose levels

Question 6

Describe the pathology that accounts for 70% of Addisons?

Answer 6

Auto antibodies that attack the adrenal cortex

Question 7

What % of cases will about for autoimmune Addisons disease?

Answer 7

70%

Question 8

True/False

Addisons disease is more common in men

Answer 8

FLASE

Addisons disease is more common in women

Question 9

What is the name of the adrenal hormone secreted from the hypothalamus that acts on the pituitary?

Answer 9

Corticotrophin releasing factor

CRF

Question 10

What is the name of the adrenal hormone that gets secreted from the Pituitary and acts on the adrenal cortex?

Answer 10

ACTH

Adrenocorticotrophic hormone

Question 11

What feedback system controls hypothalamic pituitary axis?

Answer 11

Negative feedback

Question 12

Whats is the name of the axis that controls the secretion of cortisol from the adrenal cortex?

Answer 12

Hypothalamic pituitary axis

Question 13

What are the 3 T’s a patient with Addisons disease will present with?

Answer 13

Tanned
Tired
Tearful

Question 14

What are the 5 symptoms that are a result from low glucocorticoids in Addisons disease?

Answer 14

1. Generalised weakness
2. tiredness
3. Anorexia
4. weight loss
5. Pigmentations of the skin

Question 15

What are the 2 symptoms that are a result from low androgens in Addisons disease?

Answer 15

1. Less pubic and axillary hair

2. low libido

Question 16

True/False

Patients with Addisons disease have primary hypertension?

Answer 16

False

Patients with Addisons disease have postural hypertension

Question 17

What 2 blood pressure changes are visible in a patient with Addisons disease?

Answer 17

Lower BP

tachycardia

Question 18

How might Addisons disease affect blood gluose levels?

Answer 18

Hypoglycaemia

Due to low levels of cortisol that is involved in increasing blood glucose levels.

Question 19

What 4 GI disturbances will be seen on a patient with Addisons disease?

Answer 19

1. Diarrhoea
   2 Vomiting
2. Nausea
3. Abdominal pain

Question 20

Why is a differential diagnosis for Addisons disease?

Answer 20

Thyroid disorders

Question 21

What are 3 blood result findings in Addisons?

Answer 21

1. Hypokalaemia
2. Hyponatremia
3. Elevated urea

Question 22

Why must a CT scan be carried out when suspected of Addisons disease?

Answer 22

To check for tumours or enlargement of the adrenal glands

Question 23

Would ACTH levels be high or low in Addisons disease?

Answer 23

High

Question 24

The presence of ? should always be checked for in Addisons disease

Answer 24

Auto-antibodies

Question 25

What is the name of the glucocorticoid replacement therapy for Addisons disease?

Answer 25

Hydrocortisone

Question 26

What is the name of the mineralocorticoid used for treating Addisons disease?

Answer 26

Fludrocortisone

Question 27

What is responsible for the secretion of GH?

Answer 27

Anterior pituitary

Question 28

What is acromegaly characterised by?

Answer 28

Prolonged exposure and increased secretion of GH

Question 29

What aetiology accounts for 99% of acromegaly cases?

Answer 29

Adrenal or pituitary tumours and hyperplasia

Question 30

Which type of cancers can also cause release of GH/GHRH and result in acromegaly?

Answer 30

Lung and pancreatic cancers

Question 31

What cause the presentation of clinical features seen in acromegaly?

Answer 31

Prolonged and excess GH exposure that results in somatic and metabolic effects

Question 32

What is hyperhidrosis seen in acromegaly?

Answer 32

Increased sweating

Question 33

What is Bitemporal Hemianopia seen in acromegaly?

Answer 33

Its the loss of vision in the outer half of the eyes

Question 34

What causes bitemporal hemianopia?

Answer 34

Compression of the optic chiasm from a significant pituitary adenoma

Question 35

What complication is present in 40% of acromegaly patients?

Answer 35

Impaired glucose tolerance T2DM

Question 36

Name 4 cardiovascular complications that can arise as a result of acromegaly?

Answer 36

1. Arrhythmia 2. hypertension 3. LV hypertrophy 4. cardiomyopathy

Question 37

What is the primary blood investigation for acromegaly?

Answer 37

IGF-1 insulin-like growth factor-1 reflect GH secretion and correlates with features of acromegaly

Question 38

What is 1st line treatment for acromegaly?

Answer 38

Transphenodial surgery

Question 39

What does Transphenodial surgery involve?

Answer 39

Removal of the tumours on the pituitary gland

Question 40

What is another name for somatostatin?

Answer 40

Growth hormone inhibiting hormone

Question 41

Name a somatostatin analogue that can be used as 2nd line to treat acromegaly?

Answer 41

Octreoide

Question 42

Name a dopamine agonist that can be used to treat acromegaly?

Answer 42

Bromocripitine

Question 43

What is 3rd line treatment in treating acromegaly?

Answer 43

Radiotherapy

Question 44

What 3 structures secrete somatostatin?

Answer 44

1. brain 2. GI tract 3. pancrease

Question 45

Which hormone is more potent in inhibiting GH release? somatostatin dopamine

Answer 45

Somatostatin