Flashcards in Adrenal Glands Deck (46):
What is the purpose of the adrenal glands?
Produce hormones that enable patients to cope with changing environments
Where are the adrenal glands located?
A pair of small glands that rest on the superior pole of each kidney
What is the collective name for the hormones that they adrenal glands produce?
What are corticoids that effect sodium and potassium
What are corticoids that regulate carbohydrate metabolism?
These are sex hormone precursors?
This hormone is produced by the anterior pituitary and regulates glucocorticoid and gonadocorticoid synthesis
ACTH (adrenocorticotroptic hormone)
What controls ACTH?
CRH (corticotropic releasing hormone) from the hypothalamus
What regulates the minerocorticoid pathway
What is secreted by nephrons in response to blood pressure and to sodium levels in the nephron’s tubules.
What is the plasma substrate from which renin produces angiotensin I.
What converts angiotensin 1 into angiotensin 2?
Pulmonary converting enzyme
What stimulates aldosterone secretion and sodium and water retention
The conversion of angiotensin 1 to angiotensin 2
This disease is the result of excess glucocorticoids
What causes high levels of glucocorticoids?
-Prolonged ACTH stimulation
-Glucocorticoid therapy for other treatments
What is primary disease?
Effects the organ itself
What is secondary disease?
Involves an organ or cause elsewhere
This is a way to describe any condition that produces an elevation in glucocorticoid levels.
This is when the disorder is caused by a pituitary lesion. It is named after the neurosurgeon who first published the description of the disease
Characteristics of Cushing's Disease
-Fat deposition in abdomen and base of neck
What can cause the production of accessive ACTH?
What are causes of secondary cushing syndrome?
This is hypersecretion of the aldosterone secreting cells of the adrenal cortex
What is another name for primary hyperaldosteronism?
What can cause Conns Syndrome/ Primary Hyperaldosteronism
What can Conns syndrome result in?
-Systemic hypertension due to sodium and water retention of the kidney
What is the basic idea behind secondary hyperaldosteronism?
-Aldosterone is released in response to activation of the RAA system
What are examples of things that cause secondary hyperaldosteronism?
-Decreased renal perfusion
What are causes of adrenocortical hyposecretion?
-Destruction of the adrenal cortex
-Suppression of ACTH by high therapeutic doses of glucocorticoids
What is the most common cause of Adrenocortical hyposecretion?
Autoimmune disease in which destruction of the adrenal gland occurs causing inability to secrete adequate amounts of corticosteroids.
Addisons disease- Primary Adrenocortical insufficiency
What are symptoms of Addisons disease- Primary Adrenocortical insufficiency
-Hyperpigmentation of skin
Any disorder of the hypothalamus and pituitary such as metastatic cancer, infection, infarction or irradiation that reduces the output of ACTH.
Secondary adrenocortical insufficiency
What are symptoms of Secondary adrenocortical insufficiency
-NO Hyperpigmentation of skin
These 2 levels can be measured but are difficult to interpret sometimes due to the effects of stress and sleep cycle variations
T/F- tests that evaluate cortisol and ACTH response to physiologic factors may be more reliable.
Almost all cortisol is bound to...?
Cortisol binding globulin
When is plasma cortisol the highest? Lowest?
-8 am is highest
-11 am is lowest
This measures the degree to which plasma cortisol exceeds protein binding capacity
Urine free cortisol
What are precursors of cortisol that can be measured when trying to establish a diagnosis of congenital adrenal hyperplasia?
This is the major androgen produced by the adrenal gland and can be measured in the plasma or the urine
During this test... patient is given a dose of dexamethasone (synthetic steroid) which should suppress ACTH production and therefore decrease cortisol.
Dexamethasone Suppression Test
This test... uses synthetic bioactive ACTH to test adrenal cortisol producing ability
Cortrosyn Stimulation Test
Laboratory Findings with Cushings disease (ACTH, urine free cortisol, d-suppression test)
-Elevated ACTH levels
-Elevated Urine Free Cortisol levels
-Dexamethasone Suppression Test reveals failure to suppress cortisol levels
Laboratory Findings with Cushing’s Syndrome (urine free cortisol, ACTH)
-Elevated Urine Free Cortisol levels
-ACTH will typically be elevated but will be depressed if adrenal tumor secreting increased cortisol.