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Flashcards in endocrine-adrenal cortex Deck (22)
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1

what are the 3 layers of the adrenal cortex

zona glomerulosa
zona fasciculata
zona retircularis

2

what do the 3 zones of the adrenal cortex secrete

zona glomerulosa- mineralcorticoids
zona fasciculata- glucocorticoids
zona retircularis- androgens

3

why do you seen muscle weakness and thin extremeties in Cushing's syndrome

cortisol breaks muscle producing amino acids for gluconeogenesis

4

why do you see abdominal striae in Cushing's syndrome

due to impaired synthesis of collagen with thinning of skin

5

Cushing's syndrome with bilateral atrophic adrenal glands..whats the cause

exogenous corticosteroid use

6

Cushing's syndrome with unilateral atrophic adrenal gland..whats the cause?

primary adrenal adenoma, hyperplasia or carcinoma

7

Cushing's syndrome with bilateral hypertrophic adrenal glands..whats the cause?

ACTH secreting pituitary adenoma OR paraneoplastic ACTH secretion

8

how could you tell the difference between an ACTH secreting pituitary adenoma or a paraneoplastic ACTH secreting tumor

high dose dexamethasone (cortisol analog) which suppresses ACTH production by a pituitary adenoma (cortisol levels will decrease) but fails to suppress ectopic ACTH from a paraneoplastic source

9

what is conn syndrome

hyperaldosteronism

10

will you see metabolic acidosis or alkalosis in conn syndrome? why?

metabolic alkalosis because aldosterone causes secretion of H in the distal tubules and collecting duct

11

what is the most common cause of primary hyperaldosteronism

sporadic adrenal hyperplasia

12

in primary hyperaldosteronism, will the renin levels be elevated or depressed

depressed (high BP down regulates renin via negative feedback)

13

when will you see high aldosterone and high renin

in secondary hyperaldosteronism seen with activation of the renin-angiotensin system (ex. in renovascular HTN or CHF)

14

what is the most common cause of congenital adrenal hyperplasia

inherited 21 hydroxylase deficiency

15

production of __ and ___ requires 21 hydroxylase

required for production of aldosterone and corticosteroids

16

what do you see bilateral adrenal hyperplasia in CAH

deficiency of cortisol causes increased ACTH (due to lack of negative feedback)

17

what are the consequences of the increase in the sex steroid production seen in CAH

clitoral enlargement (females) or prcocious puberty (males) due to excess androgens

18

what is syndrome
"hemorrhage necrosis of the adrenal glands classically due to DIC in young children"

waterhouse friderichsen syndrome

19

what infection classically precedes waterhouse friderichsen syndrome?

N. meningitidis infection

20

what is addison's disease

chronic adrenal insufficiency

21

what is the most common cause of addison's disease in western countries? developing world?

western countries-autoimmune destruction
developing world-TB

22

what are some clinical features of addison's disease

hypotension
hyponatremia
hypovolemia
hyperkalemia
weakness
hyperpigmentation (increased ACTH by products stimulate melanocyte production of pigment
vomiting and diarrhea