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Flashcards in Adrenal Glands Deck (46):
1

What is the purpose of the adrenal glands?

Produce hormones that enable patients to cope with changing environments

2

Where are the adrenal glands located?

A pair of small glands that rest on the superior pole of each kidney

3

What is the collective name for the hormones that they adrenal glands produce?

Corticosteroids

4

What are corticoids that effect sodium and potassium

Mineralocorticoids

5

What are corticoids that regulate carbohydrate metabolism?

Glucocorticoids

6

These are sex hormone precursors?

Gonadocorticoids

7

This hormone is produced by the anterior pituitary and regulates glucocorticoid and gonadocorticoid synthesis

ACTH (adrenocorticotroptic hormone)

8

What controls ACTH?

CRH (corticotropic releasing hormone) from the hypothalamus

9

What regulates the minerocorticoid pathway

Angiotensin 2

10

What is secreted by nephrons in response to blood pressure and to sodium levels in the nephron’s tubules.

Renin

11

What is the plasma substrate from which renin produces angiotensin I.

Angiotensinogen

12

What converts angiotensin 1 into angiotensin 2?

Pulmonary converting enzyme

13

What stimulates aldosterone secretion and sodium and water retention

The conversion of angiotensin 1 to angiotensin 2

14

This disease is the result of excess glucocorticoids

Cushings Syndrome/Disease

15

What causes high levels of glucocorticoids?

-Prolonged ACTH stimulation
-Glucocorticoid therapy for other treatments
-Adrenal Tumors

16

What is primary disease?

Effects the organ itself

17

What is secondary disease?

Involves an organ or cause elsewhere

18

This is a way to describe any condition that produces an elevation in glucocorticoid levels.

Cushings syndrome

19

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

Cushings disease

20

Characteristics of Cushing's Disease

-Moon face
-Muscle weakness
-Hypertension
-Fat deposition in abdomen and base of neck

21

What can cause the production of accessive ACTH?

Pituitary tumor

22

What are causes of secondary cushing syndrome?

-Hypothalamus tumor
-Non-endocrine tumor
-Brochogenic carcinoma

23

This is hypersecretion of the aldosterone secreting cells of the adrenal cortex

Primary Hyperaldosteronism

24

What is another name for primary hyperaldosteronism?

Conn's syndrome

25

What can cause Conns Syndrome/ Primary Hyperaldosteronism

-Cortical adenoma

26

What can Conns syndrome result in?

-Systemic hypertension due to sodium and water retention of the kidney

27

What is the basic idea behind secondary hyperaldosteronism?

-Aldosterone is released in response to activation of the RAA system

28

What are examples of things that cause secondary hyperaldosteronism?

-CHF
-Pregnancy
-Decreased renal perfusion
-Hypoalbuminemia

29

What are causes of adrenocortical hyposecretion?

-Destruction of the adrenal cortex
-Suppression of ACTH by high therapeutic doses of glucocorticoids
-Infection
-Tumor
-Adrenal infarction

30

What is the most common cause of Adrenocortical hyposecretion?

Addisons disease

31

Autoimmune disease in which destruction of the adrenal gland occurs causing inability to secrete adequate amounts of corticosteroids.

Addisons disease- Primary Adrenocortical insufficiency

32

What are symptoms of Addisons disease- Primary Adrenocortical insufficiency

-Weakness
-Fatigue
-Anorexia
-Hyperpigmentation of skin

33

Any disorder of the hypothalamus and pituitary such as metastatic cancer, infection, infarction or irradiation that reduces the output of ACTH.

Secondary adrenocortical insufficiency

34

What are symptoms of Secondary adrenocortical insufficiency

-Weakness
-Fatigue
-Anorexia
-NO Hyperpigmentation of skin

35

These 2 levels can be measured but are difficult to interpret sometimes due to the effects of stress and sleep cycle variations

-Cortisol
-ACTH

36

T/F- tests that evaluate cortisol and ACTH response to physiologic factors may be more reliable.

True

37

Almost all cortisol is bound to...?

Cortisol binding globulin

38

When is plasma cortisol the highest? Lowest?

-8 am is highest
-11 am is lowest

39

This measures the degree to which plasma cortisol exceeds protein binding capacity

Urine free cortisol

40

What are precursors of cortisol that can be measured when trying to establish a diagnosis of congenital adrenal hyperplasia?

-17-Hydroxysteriods
-17-Ketosteroids

41

This is the major androgen produced by the adrenal gland and can be measured in the plasma or the urine

DHEA-S

42

During this test... patient is given a dose of dexamethasone (synthetic steroid) which should suppress ACTH production and therefore decrease cortisol.

Dexamethasone Suppression Test

43

This test... uses synthetic bioactive ACTH to test adrenal cortisol producing ability

Cortrosyn Stimulation Test

44

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

45

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.

46

Laboratory findings with adrenal insufficiency

-Addison’s disease will show an elevated ACTH and low plasma and urine cortisol levels.
-Cortrosyn Stimulation test will reveal no increase in cortisol levels.
-Secondary cases of insufficiency will show a depressed ACTH and cortisol level.