Adrenal Glands and Disorders Flashcards Preview

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Flashcards in Adrenal Glands and Disorders Deck (69)
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1

____ is formed in the adrenal glomerulosa

mineralocorticoids

2

predominant mineralocorticoid

aldosterone

3

____ is formed in the adrenal fasiculata

glucocorticoids

4

primary glucocorticoid

cortisol

5

____ is formed in the adrenal reticularis

gonadocorticoids

6

predominant gonadocorticoids

testosterone

7

Aldosterone promotes __ reabsoprtion and __ excretion

Na reabsorption and K excretion

8

aldosterone production is stimulated by the ________ apparatus in the kidney

juxtaglomerular

9

The production of cortisol is controlled by____

ACTH

10

When is cortisol highest and lowest?

highest first thing, lowest late at night

11

where is Na reabsorption promoted by aldosterone?

DCT and collecting duct

12

Main effects of cortisol on the body?

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

13

androgens produced by the adrenal glands

DHEA, testosterone

14

Produced in the adrenal medulla?

epinephrine (80%), norepinephrin (20%)

15

Congenital adrenal hyperplasias are inherited in a ____ manner

Autosommal recessive

16

Pathophysiology in congenital adrenal hyperplasia

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

17

most common enzyme deficiency in congenital adrenal hyperplasia

21a hydroxylase

18

presentation of congenital adrenal hyperplasia

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

19

treatment for congenital adrenal hyperplasa

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

20

Conn's syndrome is...

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

21

Common cause of Conn's syndrome

35% are due to benign adenomas

22

What does a Conn's adenoma look like?

small bright yellow tumour of spironolactone bodies

23

common symptoms of conn's syndrome?

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

24

What is the effect of hyperaldosteronism on electrolytes?

increased Na, decreased K

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