Adrenal disorders

Question 1

What is Addison’s disease?

Answer 1

Adrenal failure

Question 2

What is Cushing’s syndrome characterised by?

Answer 2

Excess cortisol

Question 3

What does the left adrenal vein drain into?

Answer 3

Renal vein

Question 4

What does the right adrenal vein drain into?

Answer 4

IVC

Question 5

Why is it important to vaccinate people with HIB and pneumovax before elective left adrenalectomy

Answer 5

Left adrenalectomy can result in accidental loss of spleen

Question 6

What does the zona glomerulosa produce?

Answer 6

Aldosterone

Question 7

What does the zona fasciculata produce?

Answer 7

Cortisol

Question 8

What does the zona reticularis produce?

Answer 8

Sex steroids

Question 9

What does the adrenal medulla produce?

Answer 9

Adrenaline

Question 10

Which hormones produced by the adrenal gland are steroids?

Answer 10

Cortisol
Aldosterone
Sex steroids

Question 11

What is the precursor for all steroid hormones?

Answer 11

Cholesterol

Question 12

How is cholesterol used to produce hormones?

Answer 12

Modified by enzymes

Question 13

What is POMC?

Answer 13

A large precursor protein

Cleaved to produce ACTH, MSH and endorphins

Question 14

What are the causes of Addison’s disease?

Answer 14

Autoimmune

Tuberculosis

Question 15

What occurs as adrenal glands begin to fail?

Answer 15

Pituitary increases production of ACTH and MSH to support production of cortisol
But adrenal glands can’t produce cortisol

Question 16

What does high levels of MSH cause?

Answer 16

Increased pigmentation

Question 17

What are the features of Addison’s disease?

Answer 17

Increased pigmentation
Autoimmune vitiligo may coexist
No cortisol or aldosterone so low BP
Low sodium
High potassium

Question 18

What are the biological actions of excess cortisol?

Answer 18

Impaired glucose tolerance
Mental changes
Hypertension

Question 19

Name 8 visible features caused by excess cortisol?

Answer 19

Weight gain and fat redistribution
Thin skin and easy bruising
Striae
Proximal myopathy
Moon face 
Buffalo hump
Facial hair
Acne

Question 20

Name 4 causes of Cushing’s syndrome

Answer 20

Oral steroids
Pituitary adenoma
Ectopic ACTH
Adrenal adenoma or carcinoma

Question 21

What is Cushing’s disease?

Answer 21

Cushing’s syndrome caused by Pituitary adenoma

Question 22

What are 6 clinical signs of Cushing’s syndrome

Answer 22

Thin skin
Proximal myopathy
Centripetal obesity 
Diabetes, hypertension and osteoporosis
Immunosuppression
Moon face

Question 23

What causes the same features as Cushing’s syndrome?

Answer 23

Steroids

Question 24

What would a tumour in the Zone glomerulosa cause?

Answer 24

Excess aldosterone production

Question 25

What characterises Conn's syndrome?

Answer 25

Aldosterone producing adenoma

Question 26

What are the features of Conn's syndrome?

Answer 26

Hypertension Peripheral oedema as retain sodium Low potassium

Question 27

What hormone regulates the production of Cortisol?

Answer 27

ACTH

Question 28

Where is POMC produced?

Answer 28

Pituitary gland

Question 29

What does POMC stand for?

Answer 29

Pro-opio-melanocortin

Question 30

What is POMC broken down into?

Answer 30

ACTH & MSH

Question 31

How many veins do each adrenal gland have?

Answer 31

1

Question 32

What can't people with Cushing's syndrome do?

Answer 32

Squat | due to proximal myopathy