Lecture 6 - Adrenal Flashcards Preview

ICM - Endocrine > Lecture 6 - Adrenal > Flashcards

Flashcards in Lecture 6 - Adrenal Deck (22):
1

adrenal cortex/what it secretes:
G =
F =
R =

glomerulosa = aldosterone
fasiculata = glucocorticoids
reticularis = sex steroids

2

enzyme responsible for rate limiting step of steroid synth:

stimulated by ____

cholesterol desmolase (ie cholesterol --> pregnenolone)

ACTH

3

ACTH comes from what precursor? what other important molecule comes from the same precursor?

this molecule causes _____

proopiomelanocortin (POMC);

MSH (melanotropin)

pigmentation

4

cushing:
exogenous corticosteroids result in ____ ACTH. what happens to the adrenals?

decreased;
bilateral adrenal atrophy

most common cause

5

primary adrenal adenoma, hyperplasia:
ACTH levels?
what happens to adrenal gland?

decreased;
contralateral atrophy

6

cushing disease:
what is it?
ACTH levels?
what happens to adrenals?
respond to high dose dexa?

ACTH secreting pit adenoma;
high
bilateral hyperplasia;
yes (ie it decreases)

7

ectopic ACTH secretion:
common tumor involved?
respond to high dose dexa?

small cell lung cancer (or pancreatric or bronchial carcinoid);
no (ie levels stay high)

8

cushing's syndrome symptoms:
hypertension due to ____
___glycemia;
skin thinning due to _____

etc etc

increased alpha 1 receptors;
hyper;
decreased fibroblasts

9

cushing's diagnostic:
increased 24 hour _____;
increased late night _____;
inadequate suppression on low dose ____

urine free cortisol;
salivary cortisol;
dexa

10

after confirming cushing syndrome, next step is to

measure ACTH

11

CRH stimulation test:
increase in ACTH and cortisol occurs with ____;
no increase in ACTH and cortisol occurs with ____

cushing disease;
ectopic ACTH

12

special studies for cushing:
_____ sampling is cold standard. inject ____, sample _____

petrosal sinus;
CRH, ACTH

13

treatment of cushing disease:

pituitary surgery or radiation

meds rarely used

14

adrenal insufficiency (ACTH levels/pigmentation?):
primary =
secondary =
tertiary =

v high, yes;
low (decreased pit production), no;
low (ie chronic exogenous use), no

15

addison = ____ adrenal insufficiency

due to ____ in the western world;
____ in the developing world;
metastatic ___ cancer

chronic;

auto-immune disease;
Tb;
lung

16

addison's:
decreased aldosterone causes ___tension, ____kalemia, metabolic ____.
____glycemia

hypo, hyper, acidosis;
hypo

17

treatment of addisons:
replace ___ and ____

glucocorticoids and mineralocorticoids

18

hyperaldosteronism:
see ___tension, ____natremia, ____kalemia, metabolic _____

hyper, hyper, hypo;
acidosis

esp diastolic HTN

19

primary hyperaldosteronism:
can be due to conn syndrome = _____;
or bilateral adrenal hyperplasioa

adrenal adenoma

20

primary aldosteronism:
____ aldosterone, ____ renin

high, low

21

secondary aldosteornism:
____ HTN, ____ tumors

renovascular (ie stenosis, fibromuscular dysplasia);
juxtaglomerular cell

22

secondary aldosteronism:
see ___ aldosterone, _____ renin

increased, increased