Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2- Endocrine System > Adrenal Gland- clinical aspects > Flashcards

Adrenal Gland- clinical aspects Flashcards

1
Q

RECAP- which hormone does the zona glomerulosa produce?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RECAP- which hormone does the zona fasciculata produce?

A

Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

RECAP- which hormone does the zona reticularis produce?

A

Testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

RECAP- which hormones does the adrenal cortex produce?

A

Norepinephrine
Epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the role of aldpsterone?

A

Water-salt balance
Helps absorb water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the role of cortisol?

A

Helps with energy balance and maintains glucose levels
Counter-regulatory for BG levels, opposite of insulin basically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How are hormones, like cortisol, produced from cholesterol?

A

Cholesterol converted to progesterone.
221-hydroxylase leads to formation of cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Long term use of which type of drug can cause adrenal suppression?

A

Steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which marker is usually present in the majority of cases of autoimmune Addison’s disorder?

A

Adrenal autoanitbodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the pathology behind Addison’s disease?

A

Autoimmune destruction causing an infiltration of lymphocytes into the adrenal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Like other autoimmune conditions, if you have Addison’s you are more likely to have another autoimmune related problem.
What are some of the likely autoimmune conditions associated with Addison’s?

A

Thyroid disease
Type 1 diabetes
Premature ovarian failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List some of the symptoms of primary adrenal failure.

A

Weakness, fatigue, weight loss.
Skin pigmentation
Hypotension
Unexplained vomiting or diarrhoea
Salt craving
Postural symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some possible clues that point towards adrenal failure?

A

Disproportion between severity of illness and circulatory collapse/hypotension/dehydration.
Unexplained hypoglycaemia
Previous depression or weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which investigations can be carried out to assist in the diagnosis of adrenal insufficiency?

A

Routine bloods- U&E, glucose, FBC
Random cortisol
Synacthen test/ rapid ACTH stimulation test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In the U&E blood test in someone with adrenal insufficiency, what is a classical pattern?

A

High potassium and low sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If carrying out a random cortisol test and it is >450nmol/L, what is it likely NOT to be?

A

Addison’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is the best time to do a random cortisol test?

A

Early in the morning or when the patient is presenting with an extreme illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If the Synacthen test is abnormal and suggestive of adrenal insufficiency, which further test is carried out?

A

Plasma ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In testing plasma ACTH, if levels are elevated, what does this tell us about the adrenal insufficiency?

A

It is primary adrenocortical insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In testing plasma ACTH, if levels are supressed, what does this tell us about the adrenal insufficiency?

A

Secondary adrenocortical insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment for someone with adrenocortical insufficiency?

A

Glucocorticoid replacement as these steroid hormones are essential for life

->most likely hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do patients on steroids need to have on them?

A

Some form of identification at all time in case they come in unconscious or are steroid dependant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What happens to the amount of steroids produced by the body when under stress?

A

Amount of steroids produced increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

If a patient is on long-term steroids, what happens if they are under stress or illness?

A

Body cannot produced adequate steroids itself to respond so patient needs to increase their steroid dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are three rules for patients on steroid?

A
  1. Never miss a dose
  2. Double the hydrocortisone dose in event of intercurrent illness, like flu, UTI
  3. If severe diarrhoea or vomiting, get help straight away
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How is blood pressure linked to hyperfunction of the adrenal gland?

A

Causes hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hyperaldosteronism?

A

Condition is which the body produces too much aldosterone

28
Q

RECAP- Cushing’s syndrome?

A

Excess corticosteroids produced by the body

29
Q

Which gland produces too many aldosterone hormones in Cushing’s syndrome?

A

Adrenal gland

30
Q

RECAP- is cortisol a catabolic or anabolic hormone?

A

Catabolic

31
Q

What are the roles of cortisol?

A

-Tissue breakdown
-Sodium retention
-Insulin antagonism

32
Q

What happens as a result of the catabolic nature pf cortisol when breaking down tissues?

A

Causes weakness of the sin, muscle and bone

33
Q

What happens as a result of too much cortisol regarding sodium retention?

A

May cause hypertension and heart failure

34
Q

What can happen if there is too much cortisol in regards to diabetes?

A

More likely to cause diabetes as cortisol is an insulin antagonist

35
Q

What does cortisol cause to happen in adipose tissue?

A

Lipolysis- breakdown of fat leading to thinning of the skin

36
Q

Why do those with Cushing’s syndrome get depositions of fa around the face and central trunk?

A

Release of free fatty acids due to lipolysis increasing BG levels.
High levels of insulin as a result.
This causes he deposition of fat.

37
Q

Which types of movement do those with Cushing’s struggle with?

A

Getting up from sitting
Reaching high up things

38
Q

RECAP- list the symptoms of Cushing’s/

A

Moon face
Muscle atrophy
Muscle replaced w fat
Thin arms and legs
Easily bruised
Red striae
Oedema
Diabetes
Cardiac failure
Central obesity
Hypertension

39
Q

Cushing’s syndrome can be described as being ACTH dependant or independent.

What causes ACTH dependant Cushing’s?

A

Pituitary tumour- this is known as Cushing’s disease
Ectopic ACTH secretion

40
Q

Cushing’s syndrome can be described as being ACTH dependant or independent.

What causes ACTH independant Cushing’s?

A

Adrenal tumour

41
Q

Which gland is producing the excess ACTH in Cushing’s disease?

A

Pituitary

42
Q

RECAP- in normal people, when is the body’s level of cortisol the highest?

A

When we wake up, early in the morning

43
Q

What system controls the release of aldesterone?

A

RAAS
Renin-angiotensin-aldosterone-system

44
Q

Regarding the RAAS, what converts angiotensinogen into angiotensin 1?

A

Renin

45
Q

Regarding the RAAS, what converts Angiotensin 1 into Angiotensin 2?

A

Angiotensin-converting enzyme

46
Q

How does hyperaldosteronism increase blood presure?

A

Acts on distal renal tubules to increase sodium, also increasing absorption of water.
This increases blood volume which increases blood pressure

47
Q

In screening for Conn’s disease or primary hyperaldosteronism, what does the ration of aldosterone:renin have to be greater than to indicate primary hyperaldosteronism?

A

Greater than 20x

48
Q

What happens to potassium levels in hypertension?

A

They fall, potentially causing hypokalaemia.

->this is because sodium levels increase as sodium and water are absorbed so potassium is excreted

49
Q

Which two hormone based conditions can cause hypertension relating to RAAS?

A

Cushing’s
Conn’s

50
Q

What is Conn’s disease?

A

A hormonal condition in which one or both adrenal glands overproduce mineral corticoids from the zona glomerulosa

51
Q

What is Pheochromocytoma?

A

A type of neuroendocrine tumour than grows from chromaffin cells.

52
Q

Which symptom is present in majority with
Pheochromocytoma?

A

Hypertension

53
Q

What are some other symptoms of a Pheochromocytoma?

A

Paroxysmal attacks
Headache
Sweating
Palpitations
Tremor
Pallor
Anxiety

54
Q

What part of the adrenal gland is Pheochromocytoma associated with?

A

Adrenal medulla

55
Q

What effect does a Pheochromocytoma have on blood glucose levels?

A

Hyperglycaemic effect

56
Q

What do you do clinically if you have a suspicion than someone has Pheochromocytoma?

A

24hr urine collection to measure plasma metanephrines

57
Q

What problems may arise when trying to remove a Pheochromocytoma?

A

When you touch the lesion, there is a high chance it releases a load of catecholamines into bloodstream.
This causes a rise in BP, causes tachycardia and potentially cardiac arrest

58
Q

RECAP- which type of drug is used in tachycardia?

A

Beta blockers

59
Q

Why does a deficit in hydroxylase cause adrenal hyperplasia?

A

-Lack of 21-hydroxylase to inhibit the synthesis of cortisol
-This removes the negative feedback on ACTH and CRH release
-Increased ACTH secretion responsible for the enlargement of adrenal glands

60
Q

What is the cause of the vast majority of cases of congenital adrenal hyperplasia?

A

21-hydoxylase deficiency

61
Q

In severe cases of congenital adrenal hyperplasia, what are some of the other issues?

A

Neonatal salt-losing crisis
Ambiguous genitalia in females*

*this is due to a shunt in which more testosterone is produced to make up for aldosterone

62
Q

In incomplete defected cases of congenital adrenal hyperplasia, what are some of the other issues?

A

Pseudo-precocious puberty in boys
Hirsutism in women
m

63
Q

Which part of the adrenal gland produces too much catecholamines in Cushing’s?

A

Adrenal medulla

64
Q

Which part of the adrenal gland produces too much corticoids in Conn’s?

A

Zona glomerulosa part of adrenal cortex

65
Q
A

Year 2- Endocrine System (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions