Endo 4 - Adrenal Hormones and Disorders Flashcards Preview

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Flashcards in Endo 4 - Adrenal Hormones and Disorders Deck (46):
1

3 most important hormones of the adrenal cortex

cortisol aldosterone dehydroepiandrosterone

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2

what type of hormone is cortisol

glucocorticoid

3

what type of hormone is aldosterone

mineralcorticoid

4

what type of hormone is DHEA

androgen

5

Hormone axis for cortisol

CRH => ACTH => cortisol

6

T/F stress increases CRH release

TRUE

7

T/F cortisol increases CRH release

FALSE (negative feedback)

8

method of secretion for ACTH

pulsing

9

what can disrupt the pulsing rhythmic secretion of ACTH

stress

10

highest peak of cortisol

4-7 AM

11

ACTH binds and activates what?

Adenyl cyclase

12

acute effect of ACTH

immediate removal of 6 C side chain from cholesterol => allows steroid synthesis

13

chronic effect of ACTH

formation of all enzymes involved in steroid synthesis

14

main controller of aldosterone secretion

RAS

15

direct stimulator of aldosterone secretion

ATII

16

Factors that increase aldosterone secretion

decreased afferent arteriolar pressure, decreased filtered sodium to DCT, potassium, ACTH, SNS

17

major function of cortisol

catabolic, gluconeogensis

18

other things cortisol does

glycogen deposition in liver, insulin resistance, anti-inflammatory

19

Aldosterone promotes sodium (1) by reducing (2)

1) retention 2) urinary sodium excretion

20

What is the effect of aldosterone on urinary K and H

increases excretion of K and H

21

DHEA function in females

axillary and pubic hair

22

Why does DHEA not have much of an effect in males

males have testosterone - much more powerful

23

5 major disorders of adrenal glands

1) insufficiency 2) hyperfunction (cushing syndrome) 3) primary hyperaldosteronism 4) congenital adrenal hyperplasia (21-H deficiency) 5) pheochromocytoma

24

test for adrenal insufficiency

ACTH stimulation test

25

3 screen tests for cushing (hyperfunction)

1) bedtime salivary cortisol 2) urine free cortisol 3) overnight 1 mg dexamethasone suppresion test

26

how to test for aldosterone overproduction

plasma aldosterone: plasma renin activity ratio > 30 = positive

27

symptoms of addison (insufficiency)

weakness, fatigue, hyperpigment, weight loss, anorexia, hypotension, hyponatremia, HYPERkalemia

28

what is secondary adrenal insufficiency

ACTH deficiency caused by withdrawal of exogenous steroids, pit tumor

29

major difference between secondary and primary insufficiency

pallor instead of hyperpigmentation, no electrolyte abnormalities, loss of axillary and pubic hair

30

major symptoms of cushing

weight gain, truncal obesity, weakness, HTN, hirsutism/amenorrhea

31

patients with ectopic (cancer secreting) ACTH have what 2 differences in symptoms

weight loss and hyperpigmentation

32

tx of cushing

surgery or pharmacologic block of steroid synthesis

33

overnight test for cushing?

dexamethasone suppresion

34

what does dexamethasone do?

it suppresses the production of cortisol

35

tx for hyperaldosteronism

surgery for adrenal adenoma spironolactone/eplerenone for adrenal hyperplasia

36

most common deficiency in CAH

21-Hydroxylase

37

2 important hormones of adrenal medulla

Epi/NE

38

test to see levels of adrenal medulla

metanephrine (metabolite of catecholamine)

39

super rare tumor causing hypertension

pheochromocytoma

40

what is a pheochromocytoma

catecholamine secreting tumor of the adrenal medulla

41

tx of pheochromocytoma

surgery

42

symptoms/signs of pheo

HTN, palpitations, tremor, sweating, pallor

43

mass lesion on adrenal gland > 1 cm

adrenal incidentaloma

44

first step after discovery of adrenal incidentaloma

make sure nodule is not functioning

45

primary adrenal insufficiency has what electrolyte abnormalities?

low Na, high K - due to loss of aldosterone function

46

classic presentation for someone w/ primary adrenal insufficiency

salt craving