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2=Endocrinology > L2 - Adrenal glands/adrenal gland dysfunction/Exogenous Steroid > Flashcards

L2 - Adrenal glands/adrenal gland dysfunction/Exogenous Steroid Flashcards

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1
Q

2 parts of adrenal gland

A

cortex and medulla

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2
Q

where are adrenaline and noradrenaline produced in the adrenal gland?

A

medulla

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3
Q

which NS is the medulla part of?

A

sympathetic

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4
Q

3 layers of cortex?

A

Zona
Glomerulosa
Fascicula
Reticularis

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5
Q

which hormones are produced in cortex?

A

corticosteriods

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6
Q

3 types of hormones produced in cortex - according to layers?

A 
G = salt = mineralcorticoid; aldosterone 
F = sugar = glucocorticoid; cortisol 
R = sex = gonadocorticoids; adrenal sex hormones
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7
Q

what type of hormone is aldosterone? why?

A

anti-duiretic - increased Na+ reabsorption, therefore water reabs. and increased in K+ output

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8
Q

what causes the release of all the hormones from the adrenal gland?

A
  1. hypothalamus
  2. anterior pituary releases ACTH (adreno-cortico tropic hormone)
  3. stimulates adrenal gland to release hormones
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9
Q

4 adrenal gland dysfunctions

A
  1. addisons disease
  2. cushings syndrome
  3. hyperaldostronism (Conn’s syndrome)
  4. androgenital syndrome
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10
Q

what is hyperaldosteronism?

A

excess aldosterone - increased Na+ causing hypertension and low K+ levels

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11
Q

what is androgenital syndrome?

A

excess production of gonadocorticoids

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12
Q

what are the sxs of androgenital syndrome

A

female hirsutism = facial hair
male psuedohermaphroditism in female infants
precocious puberty = reaching puberty earlier

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13
Q

cause of androgenital syndrome

A

defect in an enzyme in corticol steriodogenic pathway

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14
Q

what is addisons disease?

A

lack of aldosterone and cortisol production

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15
Q

addisons disease sxs

A
  • chronic fatigue
  • muscle weakness
  • decrease appetite and weight
  • skin hyperpigmentation
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16
Q

which 2 drugs are treatment for addisons?

A

fludrocortison - to replace aldosterone

hydrocortisone - to replace loss of cortisol

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17
Q

what is cushings syndrome?

A

excess glucocorticoid hormone production

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18
Q

ACTH stimulates the adrenal cortex to release what?

A

corticosteriods

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19
Q

what area of the adrenal gland prodcues aldosterone?

A

cortex

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20
Q

Damage to cells of the zona fasciculata of the adrenal cortex would result in

a) the loss of axillary and pubic hair.
b) increased volume of urine formation.
c) decreased levels of sodium ion in the blood.
d) decreased ability to convert amino acids to glucose.

A

d - main effects of cortisol is to promote gluconeogenesis

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21
Q

A rise in cortisol would cause an increase in each of the following, EXCEPT

a) the rate of glucose synthesis by the liver.
b) the level of fatty acids in the blood.
c) fatty acid metabolism by muscle cells.
d) corticotrophin levels.

A

d

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22
Q

syndrome which is a cause of secondary hypertension

A

conn’s syndrome

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23
Q

sxs and symptoms of this disease are moon face, osteoporosis, central body obesity, glucose intolerance

Study These Flashcards
A

cushings disease

24
Q

drug which is also called hydrocortisone

25
glucocorticoid which is a prodrug with a short duration of action
deflazacort
26
most common glucocorticoid drug used as anti-inflammatory and immunusupression
prednisolone
27
drug used in addisons disease in conjuction with cortisol
fludocortisone
28
2 times in the day where cortisol secretion peaks
1. early morning | 2. noon
29
3 mechanisms which control release of aldosterone?
1. stress 2. decreased Na+ and increased K+ in blood 3. decreased BP/blood volume
30
how does stress cause release of aldosterone ?
1. hypothalamus detects 2. releases corticotropin releasing hormone (CRH) 2. ant pit releases ACTH
31
how does decreased Na+ and increased K+ in blood cause release of aldosterone?
direct effect
32
how does decreased BP/blood volume cause release of aldosterone?
1. detetced by kidney 2. kidney releases renin 3. cascade produces angiotensin II
33
what hormone works to decrease BP etc?
ANP
34
4 general functions of glucocorticoids?
1. metabolic 2. permissive 3. adaptation to stress 4. anti-inflammatory/immunosuppresive
35
3 metabolic effects of cortisol?
1. hyperglycaemia 2. protein degradation 3. lipolysis
36
describe 1 permissive effect of cortisol on other hormones?
allows catecholamines (NE/E) to induce vasoconstriction
37
in terms of the cortisol short term adaptation to stress - what effects does it have?
causes adrenal medulla to secrete Ne E
38
in terms of the cortisol long term adaptation to stress - what effects does it have?
same as mineralcorticoid - CRH from hypothalamus etc
39
list 5 ways in which cortisol acts as an anti-inflammatory/immunosuppresive
1. reduce vasodilation and dec fluid exudation 2. dec number + activity of WBC 3. dec fibrosis 4. dec action/proliferation of lymphocytes 5. dec production of prostanoids/leukotrienes 6. dec generation of cytokines 7. dec complement protiens 8. dec histamine release from mast cells
40
what 2 things can excess glucocorticoid levels lead to?
1. depress bone + cartilage formation | 2. promote changes in CV, neural and GI function
41
what does the renin-angiotensin system promote the release of?
mineralcorticoids and glucocorticoids
42
when are cortisol levels the highest
morning
43
what is conn's syndrome ?
hypoaldosteronism
44
sxs of conns syndrome
hypertension - low K+
45
list 5 sxs of cushings syndrome
1. moon face 2. central body obesity 3. thin, bruised skin 4. glucose intolerance 5. hypertension 6. excess hair growth 7. osteoporosis 8. kidney stones 9. menstrual irregularity 10. emotional liability 11. increased susceptability to infections
46
2 treatments of cushing sundrome
1. surgically remove tumour | 2. drugs to inhibit cortisol production
47
3 drugs which inhibit cortisol production
1. metyrapone 2. trilostane 3. aminogluethimide
48
common use of steriod drugs
anti-inflammatory/immunosuppressive
49
why can cortisone and prednisone only be admisteretd systemically
they convert into active form by the liver
50
name 1 short acting corticoid
hydrocortisone
51
name 1 intermediate acting corticoid
predisone
52
name 1 long acting corticoid
betamethasone
53
3 side effects of large doses and long term effects of corticosteroids
1. iatrogenic cushing syndrome 2. infection/injury suppression - chicken pox 3. hypothalamic-pit-adrenal suppresion - prevents natural steriods from being produced
54
when can glucocorticoids be abruptly discontinued?
if low dose | <3 weeks
55
3 sxs of glucocorticoids withdrawal
1. fatigue 2. muscle weakness 3. arthralgia 4. nausea 5. hypotension 6. dizziness

2=Endocrinology (8 decks)

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