lecture 24

Question 1

Which adrenal gland condition is more commonly seen

Answer 1

cushings more common than addisons

Question 2

Outside region of adrenal gland

Answer 2

capsule

Question 3

outer zona region

Answer 3

glomerular

Question 4

middle zona region

Answer 4

fasciculata

Question 5

inside zona region

Answer 5

reticularis

Question 6

inner region of the adrenal glands

Answer 6

the medulla

Question 6

what hormones are secreted by adrenal glands

Answer 6

andrenocorticoids ( mineralocorticoids and glucocorticoids)
sex hormones
catecholamines

Question 7

what is released from the zona glomerulosa

Answer 7

mineralocorticoids - primarily aldosterone

Question 8

what hormone is produced by the zona fasciculata

Answer 8

glucocorticoids

Question 9

whats the main mineralcorticoid produced by adrenal glands

Answer 9

aldosterone

Question 10

whats the main glucocorticoid produced by the adrenal glands

Answer 10

cortisol

Question 11

what hormone is released from the zona reticularis

Answer 11

sex hormones

Question 12

what is secreted by the adrenal medulla

Answer 12

catecholamines

Question 13

what catecholamines mainly produced by adrenal glands

Answer 13

80% adrenaline , 20% noradrenaline

Question 14

how is cortisol released

Answer 14

stress triggers hypothalamis - increasing CRH secretion - triggers anterior pituitary to release adrenocortitrophic hormone - triggers adrenal cortex - triggers cortisol release

Question 15

cortisol levels are lower when

Answer 15

at night

Question 16

what caises release of cortisol

Answer 16

anything which puts stress on body (physical or mental)

Question 17

actions of cortisol

Answer 17

reduce glucose and amino acid uptake, increase protein synthesis and decrease protein breakdown , increases gluconeogenesis and increases lipolysis

Question 17

what are the cellular actions of cortisol

Answer 17

increase the circulating glucose levels and maintain the normal responsiveness of blood vessels to vasoconstrictive stimuli - receptors are found in many tissues
they also have effects on immune system, nervous system and kidneys
They also have antiinflammatory and immunosuppressant effects
They are very important for metabolism

Question 18

cortisol effect within the nucleus

Answer 18

effects transactivation and transrepression

Question 19

what is addisons disease due to

Answer 19

adrenocortical insufficiency due to destruction or dysfunction of the adrenal cortex - effecting both glucocorticoid and mineralcorticoid function

Question 20

when does addisons disease occur

Answer 20

when 90+% of adrenal cortices are destroyed

Question 21

who most commonly gets addisons disease

Answer 21

Adults age 30-50

Question 22

What are the symptoms of Addisons

Answer 22

Darkening areas of skin , extreme fatigue, weight loss and decreased appetite, low bp, gi disturbance, salt craving and low blood glucose

Question 23

what causes adrenal insufficiency

Answer 23

autoimmune destruction, infections, invasion, haemmorhage

Question 24

how to treat addisons

Answer 24

hyrocortisone or fludrocortisone - hydrocortisone needs to be a split dose

Question 25

what causes a requirement to increase glucocorticoid dose for addisons

Answer 25

intercurrent illnesses eg infections

Question 26

what causes secondary adrenal insufficiency

Answer 26

lack of ACTH secretion from the pituitary , can be dur to glucocorticoid drug therapy or apprupt stopping of glucocorticoid medication

Question 27

lack of corticotrophin releasing hormone secretion from the hypothalamus is

Answer 27

tertiary adrenal insufficiency

Question 28

difference in symptoms of primary vs secondary adrenal insufficiency

Answer 28

they dont show hyperpigmentation or have salt cravings

Question 29

how do glucocorticoid drugs work

Answer 29

they supress the hypothalamus and the anterior pituitary

Question 30

adrenal crisis symptoms

Answer 30

sudden, severe pain in lower back, abdomen or legs , severe vomiting , dehydration, low blood pressure and loss of consciousness

Question 31

hypersecretion of cortisol leads to

Answer 31

cushings syndrome

Question 32

what leads to hypersecretion of cortisol

Answer 32

either gland produces too much cortisol or due to drug regimes

Question 33

what is the cause of cushings disease

Answer 33

pituitary tumour

Question 34

cause of cushings syndrome

Answer 34

drug induced

Question 35

CLasses of cushings syndrome

Answer 35

ACTH dependent - body makes too much ACTH due to pituitary tumour ACTH independent - ACTH levels are low because adrenal glands make too much cortisol due to adrenal tumour or hyperplasia

Question 36

what drugs can cause iatrogenic cushings

Answer 36

glucocorticoid treatment - usually when prolonged or potent alongside a drug which metabolises CYP450 as it prolonges the action of glucocorticoids

Question 37

how to treat cushings syndrome

Answer 37

surgery to remove pituitary or adrenal gland when drug induced- gradual withdrawl of causative drug mifepristone - glucocorticoid receptor antagonist ( doesnt reduce cortisol level) metyrapone - titrate up though as it reduces cortisol level and you still need some