disorders of adrenal function Flashcards
(20 cards)
where are the adrenal glands
sit on top of the kidney
what do the adrenal glands produce
CORTEX: glucocorticoids, mineralcorticoids, sex steroids
MEDULLA: nor/epinephrine
Actions of cortisol (6)
- increase plasma glucose
- increase lipolysis
- proteins catabolised
- Na and H2O retention - BP maintenance
- anti inflammatory
- increased gastric acid production
Incidence of cushing’s syndrome
2/1mill population
Cushings syndrome M:F
1: 3-15
Cushings syndrome onset age
20-40
What is Cushings syndrome
excess blood cortisol
what is cushing’s disease
excess blood cortisol due to pituitary ACTH secreting tumour
Cushings syndrome: changes in protein and fat metabolism
body shape change, central obesity, moon face, buffalo hump, thin skin - easy bruising, osteoporosis, DM
cushings syndrome: changes in sex hormones
excess hair growth, irregular periods, problems conceiving, impotence
cushings syndrome: salt and water retention
high BP, fluid retention
Three stages of investigating for cushings disease
- screening
- confirmation of diagnosis
- differentiation of the cause
Screening/confirmation of diagnosis of cushing’s disease
urinary free cortisol
diurnal rhythm
overnight dexamethazone suppression testing
what concentration should cortisol not be at during the day
600ish
where does dexamethazone act
pituitary and hypothalamus (Same as cortisol)
what happens in an overnight LOW DOSE dexa. suppression test
cortisol measured at 8am; Dexa 1mg given at 11pm; cortisol measured at 8am the next morning
in a low dose dex. suppression test, what level of suppression is normal
signs of pseudocushings syndrome
depression, alcoholism anorexia nervosa, obesity, all accompanied by hypercorticolism
exogenous steroids causing cushing’s symptoms
inhalers, eye/nasal drops, skin creams
differentiation of cause of cushings disease
high dose suppression test, ACTH, imaging
