Adrenal Gland

Question 1

Hormones secreted by adrenal gland?

Answer 1

Adrenocorticoids- mineralocorticoids, glucocorticoids
Sex hormones
Adrenal medulla

Question 2

What are the cellular actions of cortisol?

Answer 2

Main glucocorticoid
Receptors for cortisol are found in many tissues
Increase circulating glucose level
Maintain the normal responsiveness of blood vessels to vasoconstrictive stimuli
Effects on immune system, nervous system and kidneys
Pharmacological actions (anti-inflammatory, immunosuppressant)

Question 3

What is Addison’s Disease?

Answer 3

Due to destruction or dysfunction of the entire adrenal cortex
Affects both glucocorticoid and mineralocorticoid function
Onset of disease occurs when 90% or more of both adrenal cortices are destroyed

Question 4

What are the symptoms of addison’s dieases?

Answer 4

Hyperpigmentation, Extreme fatigue, Weight loss and decreased appetite, Low blood pressure, GI disturbance, Salt craving, Hypoglycaemia

Question 5

What are the causes of addison’s disease?

Answer 5

Primary adrenal insufficiency
Autoimmune destruction of the gland
Infections
Invasion
Haemorrhage

Question 6

What is treatment of addisons disease?

Answer 6

Hydrocortisone (sometimes prednisolone or dexamethasone)
Daily adult dose of hydrocortisone is 15-30 mg
Given as a divided dose (e.g. 10 mg on waking, 5 mg at noon and 5 mg in early evening)
Intercurrent illnesses (e.g. infections) might require an increased glucocorticoid dose
Treatment is life long

Question 7

What is secondary adrenal insufficiency?

Answer 7

Lack of ACTH secretion from pituitary
Lack of corticotrophin releasing hormone secretion from the hypothalamus (tertiary)
These patients don’t show hyperpigmentation or have cravings for salt
Treatment with glucocorticoid (e.g. hydrocortisone) but mineralocorticoid is unnecessary

Question 8

What are the symptoms of an adrenal crisis?

Answer 8

Sudden, severe pain in the lower back, abdomen or legs
Severe vomiting and diarrhoea
Dehydration
Low blood pressure
Loss of consciousness

Question 9

What is Cushing’s disease?

Answer 9

Hypersecretion of cortisol
Pituitary tumour leading to increased secretion of adrenocorticotrophic hormone
Adrenocortical tumours
Tumours external to the hypothalamic-pituitary-adrenal axis