Physiology 6 - Adrenal Disorders Flashcards Preview

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Flashcards in Physiology 6 - Adrenal Disorders Deck (12)
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1
Q

Includes:

A
  • Side effects of glucocorticoid therapy
  • Withdrawel of glucocorticoid therapy
  • Loss of -ve feedback in cortisol production
  • Congenital adrenal hyperplasia
  • Cushing’s disease/syndrome
  • Addison’s Disease
  • Pheochromocytoma
2
Q

What are the side effects of exogenous glucocorticoids?

Think about the actions of cortisol

A
  • More infections (depressed immunity)
  • Muscle wastage (increased proteolysis)
  • Loss of percutaneous fat (thin, delicate skin)
3
Q

What is the danger of withdrrawing Glucocorticoid therapy?

A

Exogenenous cortisol has depressed CRH/ACTH through -ve feedback loops for a long time

This has caused the Adrenal cortex to atrophy

There’s a danger of adrenal insufficiency post withdrawel

4
Q

What everyday things can cause a loss of -ve feedback on cortisol production, and what would this cause?

A

Alcohol Caffeine and lack of sleep can all depress neurons responsible for -ve feedback of CRH/ACTH.

This enhances stress effects and boosts cortisol production

Causing a depressed immune system and so more infections

5
Q

What causes Congenital Adrenal Hyperplasia?

A

A defect in 21-hydroxylase

The enzyme involved in both Glucocorticoid and Mineralocorticoid formation (but not sex steroids)

6
Q

Describe the pathophysiology of Congenital Adrenal Hyperplasia?

A

Lack of aldosterone -> Dysfunctional salt balance

Lack of cortisol -> Dysfunctional glucose balance

Unused steroid precursors are used to make excess androgens

The lack of cortisol -ve feedback –> Excess ACTH –> Adrenal Hyperplasia

7
Q

In short what are cushing’s?

A

Hypersecretion of cortisol

8
Q

whats the difference between cushing’s disease and syndrome?

A

Cushing’s Disease occurs if the tumour is the pituitary gland (i.e. its secondary)

Cushing’s Syndrome occurs if the tumour is in the adrenal cortex (i.e. its a primary endocrine disorder)

9
Q

How does cushing’s present?

A

Wasting of the extremeties thanks to proteolysis

counter-intuitive rapid redistribution of fat to face/trunk

10
Q

What is Addison’s Disease?

A

Autoimmune descruction of the adrenal cortex leading to hyposecretion of all 3 classes of steroid hormones

11
Q

What is a pheochromocytoma?

A

A neuroendocrine tumour in the adrenal medulla resulting in excess catecholamines

12
Q

How does pheocrhomocytoma present?

A

Increases HR -> Increased BP
Increased vasoconstriction -> Increased BP

Diabetogenic. (Adrenaline stimulates lipolysis and glucogenolysis)

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