Flashcards in Adrenal Glands and Disorders Deck (69)
____ is formed in the adrenal glomerulosa
____ is formed in the adrenal fasiculata
____ is formed in the adrenal reticularis
Aldosterone promotes __ reabsoprtion and __ excretion
Na reabsorption and K excretion
aldosterone production is stimulated by the ________ apparatus in the kidney
The production of cortisol is controlled by____
When is cortisol highest and lowest?
highest first thing, lowest late at night
where is Na reabsorption promoted by aldosterone?
DCT and collecting duct
Main effects of cortisol on the body?
increased BG, anti-inflammatory effects, increased CO, BP and renal blood flow, osteoporosis, decreased wound healing
androgens produced by the adrenal glands
Produced in the adrenal medulla?
epinephrine (80%), norepinephrin (20%)
Congenital adrenal hyperplasias are inherited in a ____ manner
Pathophysiology in congenital adrenal hyperplasia
deficiency of an enzyme for steroid biosynthesis usually leading to decreased cortisol, increased ACTH and increased androgens
most common enzyme deficiency in congenital adrenal hyperplasia
presentation of congenital adrenal hyperplasia
salt wasting, simple virilising, hyperandrogenism, ambiguous genitalia (girls), poor feeding, poor weight gain, similar presentation to addisons
treatment for congenital adrenal hyperplasa
glucocorticoid replacement, possible mineralocorticoid replacement, restore fertility and achieve maximal growth
Conn's syndrome is...
usually associated with diffuse or nodular hyperplasia of both adrenal glands causing hyperaldosteronism
Common cause of Conn's syndrome
35% are due to benign adenomas
What does a Conn's adenoma look like?
small bright yellow tumour of spironolactone bodies
common symptoms of conn's syndrome?
weakness, cramps, paraesthesia, polyuria, polydipsia and sometimes increased BP; may be asymptomatic
What is the effect of hyperaldosteronism on electrolytes?
increased Na, decreased K
Primary investigation for conn's syndrome?
plasma renin:aldosterone ratio - if raised then investigate with suppression test
Suppression test for conn's syndrome?
failure of plasma aldosterone to suppress by 50% following 2L of saline
How is Conn's syndrome managed surgically?
unilateral laproscopic adrenalectomy - cure of hypokalaemia; cure of hypertension if adrenal adenoma
How is Conn's syndrome managed medically?
use of MR antagonists when bilateral adrenal hyperplasia --> spironolactone, eplerenone
Examples of MR antagonists (K+ sparing diuretics)