Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y2 Endocrine > Adrenal Glands and Disorders > Flashcards

Adrenal Glands and Disorders Flashcards

(69 cards)

Start Studying
1
Q

____ is formed in the adrenal glomerulosa

A

mineralocorticoids

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

predominant mineralocorticoid

A

aldosterone

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

____ is formed in the adrenal fasiculata

A

glucocorticoids

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

primary glucocorticoid

A

cortisol

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

____ is formed in the adrenal reticularis

A

gonadocorticoids

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

predominant gonadocorticoids

A

testosterone

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

Aldosterone promotes __ reabsoprtion and __ excretion

A

Na reabsorption and K excretion

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

aldosterone production is stimulated by the ________ apparatus in the kidney

A

juxtaglomerular

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

The production of cortisol is controlled by____

A

ACTH

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

When is cortisol highest and lowest?

A

highest first thing, lowest late at night

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

where is Na reabsorption promoted by aldosterone?

A

DCT and collecting duct

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

Main effects of cortisol on the body?

A

increased BG, anti-inflammatory effects, increased CO, BP and renal blood flow, osteoporosis, decreased wound healing

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

androgens produced by the adrenal glands

A

DHEA, testosterone

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

Produced in the adrenal medulla?

A

epinephrine (80%), norepinephrin (20%)

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

Congenital adrenal hyperplasias are inherited in a ____ manner

A

Autosommal recessive

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

Pathophysiology in congenital adrenal hyperplasia

A

deficiency of an enzyme for steroid biosynthesis usually leading to decreased cortisol, increased ACTH and increased androgens

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

most common enzyme deficiency in congenital adrenal hyperplasia

A

21a hydroxylase

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

presentation of congenital adrenal hyperplasia

A

salt wasting, simple virilising, hyperandrogenism, ambiguous genitalia (girls), poor feeding, poor weight gain, similar presentation to addisons

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

treatment for congenital adrenal hyperplasa

A

glucocorticoid replacement, possible mineralocorticoid replacement, restore fertility and achieve maximal growth

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

Conn’s syndrome is…

A

usually associated with diffuse or nodular hyperplasia of both adrenal glands causing hyperaldosteronism

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

Common cause of Conn’s syndrome

A

35% are due to benign adenomas

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

What does a Conn’s adenoma look like?

A

small bright yellow tumour of spironolactone bodies

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

common symptoms of conn’s syndrome?

A

weakness, cramps, paraesthesia, polyuria, polydipsia and sometimes increased BP; may be asymptomatic

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

What is the effect of hyperaldosteronism on electrolytes?

A

increased Na, decreased K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Primary investigation for conn's syndrome?
plasma renin:aldosterone ratio - if raised then investigate with suppression test
26
Suppression test for conn's syndrome?
failure of plasma aldosterone to suppress by 50% following 2L of saline
27
How is Conn's syndrome managed surgically?
unilateral laproscopic adrenalectomy - cure of hypokalaemia; cure of hypertension if adrenal adenoma
28
How is Conn's syndrome managed medically?
use of MR antagonists when bilateral adrenal hyperplasia --> spironolactone, eplerenone
29
Examples of MR antagonists (K+ sparing diuretics)
Spironolactone, eplerenone
30
What is the most common cause of Cushing's syndrome?
exogenous steroid use
31
Endogenous cushing's can be ACTH dependent or ACTH independent. What is meant by ACTH dependent Cushings?
ACTH is secreted from a pituitary adenoma causing Cushing's DISEASE (70%) or from an ectopic source such as SCLC or carcinoid tumours (cause adrenal hyperplasia)
32
Which form of lung cancer may cause Cushing's syndrome?
Small Cell Lung Cancer
33
Endogenous cushing's can be ACTH dependent or ACTH independent. What is meant by ACTH independent Cushings?
An adrenal adenoma or carcinoma
34
What group is Cushings most common?
women; 20-40 years
35
What are some symptoms of Cushing's? (5)
increased weight, mood changes, proximal weakness, gonadal dysfunction (irregular menses, hirsutism, erectile dysfunction), acne
36
What are some signs of Cushing's? (7)
central obesity with moon face, buffalo neck hump, skin and muscle atrophy with bruising and abdominal straie, oesteoporosis, increased BP and blood glucose, infection prone with poor wound healing
37
What is the 1st line test in Cushing's?
overnight dexamethasone suppression test - or low dose dexamethasone suppression test if unable to. Repeat to confirm
38
What is the treatment of Cushings which is iatrogenic?
withdraw/lower steroid dose where possible over 4-6 weeks (not instantly). Be aware that will not be able to respond to stress appropriately due to ACTH suppression
39
What is Nelson's syndrome?
When ACTH is produced in high levels (pituitary adenoma), there is increased skin pigmentation due to it being produced as POMC which also codes for melanin.
40
Management of Cushings disease?
remove adenoma, bilateral adrenalectomy if no obvious source
41
What is the prognosis like for Cushing's disease?
untreated has high vascular mortality; treated is good, but myopathy, obesity, menstrual irregularity, increased BP and osteoporosis often remain
42
What happens in acute adrenocortical insufficiency?
either rapid withdrawl of steroid treatment or crisis in patients who have chronic insufficiency but do not up medication on 'sick' days.
43
Other cause of Addisonian crisis
Massive adrenal haemorrhage
44
Where might a massive adrenal haemorrhage occur?
newborn, anticoagulation, DIC, septicaemia
45
What is Waterhouse-Fridericksen syndrome?
bilateral haemorrhage within the adrenal glands due to meningococcal septicaemia
46
How is an addisonian crisis managed?
Check bloods: FBC, U&Es, cortisol and ACTH, ECG, Hydrocortisone 100mg IV stat, IV fluid bolus to support BP, Monitor glucose
47
Symptoms of addisonian crisis
shock - increased HR, vasoconstriction, postural hypotension, oliguria, weak, confused, comatose
48
3 common causes of Addisons disease
Autoimmune, Infections, metastatic malignancy
49
Common autoimmune cause of Addisons disease
21hydroxylase adrenal autoantibodies (70%)
50
Common infections causing Addisons disease
TB (commonest worldwide), HIV (Kaposi's sarcoma), Fungal
51
Common malignancies causing Addisons disease
lung and breast cancers
52
When do symptoms of addisons disease start to occur?
when 90% of the gland is destroyed
53
How do patients with addisons present?
insidious onset with vague symptoms - weakness, fatigue, anorexia, N&V, weight loss, diarrhoea, low BP
54
What autoimmune diseases is Addisons associated with? (3)
T1DM, thyroid disease, pernicious anaemia
55
Skin colour is likely to be affected in addisons disease - TRUE/FALSE
TRUE - increased production of ACTH to try and stimulate production of cortisol and aldosterone
56
When might addisonian crisis occur?
due to stress i.e. infection, trauma, surgery; forgetting medication
57
Test to diagnose Addisons disease?
1. Short syntacthen stimulation test: plasma cortisol is measured before and 30mins after tetracosatide 250ug IM 2. test for autoantibodies and TB/malignancy when confirmed
58
How is the glucocorticoid deficiency managed in Addisons disease?
hydrocortisone as cortisol replacement (IV if unwell), 15-30mg.day divided into doses to mimic circadian rhythm and not after 6pm to allow sleep
59
How is mineralocorticoid deficiency managed in Addisons disease?
fludrocortion adjusted as necessary - monitor BP and K carefully when adjusting
60
What education is important for Addisons disease?
Wear identification; sick day rules (double the dose, IM if necessary), cannot stop suddenly
61
What is a phaeochromocytoma?
an adrenal medullary tumour derived from the chromaffin cells which secretes catecholamines
62
Presentation of phaeochromocytoma
labile hypertension, postural hypotension, paroxysmal sweating, headache, pallor, tachycardia, palpitations, breathlessness, constipation, anxiety, fear, weight lsos, flushing
63
Classic triad of phaeochromocytoma (90%)
hypertension, headache, sweating
64
Complications of phaeochromocytoma
caridac failure, infarction, arrhythmias, CVA, paralytic ileus
65
Diagnosis of phaeochromocytoma
urinary catecholamines and metabolites; hyperglycaemia, low, mild hypercalcaemia
66
Imaging done in phaeochromocytoma
MRI, MIBG, PET scan
67
Treatment of phaeochromocytoma
full a and b blockade - a (phenoxybenzamine) before b (atenolol)
68
10% tumour
phaeochromocytoma
69
the 10% rules of phaeochromocytoma
10% extra-adrenal, 10% bilateral, 10% biologically malignant, 10% not associated with hypertension, 25% familial

Y2 Endocrine (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions