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Flashcards in Adrenal Studies Deck (20):
1

3 zones of the adrenal cortex

Zona Glomerulosa-mineralocorticoids (aldosterone)
Zona Fasiculata-glucocorticoids (cortisol)
Zona Reticularis-androgens (testosterone

2

adrenal medulla produces

epinephrine and norepinephrine

3

aldosterone function

reabsorption of sodium and excretion of potassium

4

cortisol function

opposes insulin secretion
increase hepatic gluconeogenesis
increase blood glucose
increased during stress response
inhibits inflammation
(used to treat RA, asthma)

5

androgens examples

testosterone, DHEA

6

ACTH

pulsatile from the pituitary (peaks during early morning and late afternoon)
-stimulates secretion of cortisol

7

an AM draw of ACTH would help to diagnose

hyposecretion disorder (should be high in the morning normally)

8

a middle PM draw of ACTH would help to diagnose

hypersecretion disorder (should be low in the middle of the night)

9

conditions that cause an increase in cortisol

Cushing's disease (pituitary tumor-makes too much ACTH)
Cushing's syndrome (any other cause of increased cortisol-iatrogenic)
Stress
Obesity

10

conditions that cause a decrease in cortisol

adrenal insufficiency (failure)
Addison's disease (autoimmune destruction of the adrenal gland)
Congenital adrenal hyperplasia
hypothyroidism

11

3 screening tests used for hypercortisol

1. overnight dexamethasone suppression test (11:30p 1mg dose of dexamethasone which should suppress cortisol secretion-AM level should low)
2. 24 hour urine cortisol (unreliable)
3. 11 pm salivary cortisol (self-swab 2 nights in a row)

12

factors that influence cortisol screening tests

high estrogen states (urine free cortisol goes up in pregnancy)
Stress
Alcoholism (overtime lowers levels)
Depression (lowers)
Anorexia(lowers)
OCP (increase levels)
Hydrocortisone (increase levels)
Spironolactone (looks like cortisol)
Dexamethasone (decrease levels)
thiazides (decrease levels)
ketoconazonle (decrease levels)
Chronic corticosteroid use

13

aldosterone would be elevated in

Conn's sydrome (aldosterone secreting tumor)
congenital adrenal hyperplasia
hyponatremia
hyperkalemia

14

aldosterone would be lowered in

Addison's disase
Renin deficiency
hypernatremia
antihypertensive therapy

15

Aldosterone serum level should be drawn with patient

sitting upright and on unaltered Na diet

16

Pheochromocytoma

rare tumor of the chromaffin cells of the adrenal medulla

17

catecholamines

dopamine
epinephrine
norepinephrine
-fleeting and change constantly so not a good screening test

18

metanephrine

metabolite that stays constant in the blood stream and is used to screen for pheochromocytoma

19

normetanephrine

metabolite that stays constant in the blood stream and is used to screen for pheochromocytoma

20

instructions for getting a plasma metanephrine

1. avoid trigger foods for a few days before test
2. be drug-free if possible
3. be as stress free as possible
4. lay supine for 30 min before the draw

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