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79 Cards in this Set
- Front
- Back
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three zones of adrenal cortex
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glomerlulosa
fasciculata reicularis |
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zona glomerulosa is the _______ layer of the _______ gland
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outer layer of the adrenal gland
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the zona fasciculata is the _______ layer of the _______ gland
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middle layer of the adrenal gland
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the zona reticularis is the _______ layer of the _______ gland
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inner layer of the adrenal gland
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the zona glomerulousa is the _______ layer of the _______ gland which secretes _______
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inner layer of the addrenal gland which secretes aldosterone
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the zona fasciculata is the _______ layer of the _______ gland which secretes _______
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middle layer of the addrenal gland which secretes cortisol
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the zona reticularis is the _______ layer of the _______ gland which secretes _______
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inner layer of the addrenal which secretes testosterone
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aldosterone is a _______corticoid
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mineral
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cortisol is a _______corticoid
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gluco
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testosterone is an _______
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androgen
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aldosterone is important in _______ and _______ retention
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fluid and sodium
it is not dependent on ACCTH |
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glucocorticoids is the smallest/largest source of horomones from the addrenal gland
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largest
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androgens produce secondary _______ characteristics
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sex
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glucocorticoids are made from c_______
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choleserol
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when glucocorticoids are released they effect g_______ metabolism and how p_______ and f_______ are utilized.
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effect glucose metabolism
how protein/fats are utilized |
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how are proteins utilized when glucocoricoids are rleased
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amino acids are mobilized and transported to the liver for gluconeogenesis
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regulation of ACTH is through a _______ feedback loop
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negative
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how is the renin angiotensin aldosterone system activated?
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by fluid volume changes
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androgens are precursors of t________
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testosterone
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androgens are responsible for s________ s________ characteristics
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secondary sex
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DHEAS is used in the treatment of a________ c________ insufficiency
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adrenal corticol
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addrenal corticol insufficiency is aka ________ disease
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addisons
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the natural glucocorticoid is called c________
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cortisol
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the synthetic glucocorticoid is called p________
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predinisone
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glucocorticoids increase/decrease inflammatory and immune response
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decrease
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glucocorticoids increase/decrease circulating WBC
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decrease
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glucocorticoid use could result in decreased l________cytes, m________cytes, e________phils and an increase in n________phils
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decreased: lymphocytes, monocytes, eosinophils
increase in neutrophils |
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what are the effects of glucocorticoids on glucose availability?
3 things |
stimulates gluconeogenesis
reduces peripheral glucose utilization promote glucose storage in form of glycogen |
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glucocorticoids aka s________ hormone or anti i________ hormone
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stress hormone
anti insulin hormone |
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glucocorticoids increase protein c________
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protein catabolism
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glucocorticoids increasses plasma amino acids for g________ production in the liver
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glucose production
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glucocorticoids promote fat ________ down, aka l________ and mobilization of free f________ acids
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fat breakdown
lipolysis mobilization of free fatty acids |
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how does glucocorticoids effect the liver?
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causes degradation of protein for gluconeogenesis
^liver enzymes ^glycogen deposition decrease glycolysis stimulate glyconeogenesis inhibit peripheral glucose use |
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how does stress effect the release of glucocorticoids?
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increases it
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glucocorticoids do what the action of epi/ne
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potentiates
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glcocorticoids promote vasco constriction/dialation
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constriction
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glucocorticoids increase/decrease vascular permiability
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decrease
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glucocorticoids increase/decreas Hgb/RBC
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increase
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endogenous glucocorticoids also have a mineral________ action
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mineralcorticoid
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glucocorticoids have catabolic effects on: ....
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muscle, connective tissue, lymphoid tissue and skin structures
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glucocorticoids effects on CNS
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mood
sleep motor activity |
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glucocort effect on respiration
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relax smoothe muslce
fetal therapeutic effects think of asthmatics |
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you are seeing a child for long term management of asthma. he is taking a glucocorticoid. what developmental risk is he at risk for?
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glucocorticoids impede growth rates in children
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3 primary indications of glucocorticoids
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inflammation
immunosuppression replacement deficiency |
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glucocort inhibits interaction of ________ adhesion molecules
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cell
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glucocort affects the c________, d________ and f________ of peripheral leukocytes
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concentration
distribution function |
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how do glucocort effect prostaglandins?
remember what prostaglandins are instrumental in... |
it suppresses them.
prostaglandins are apart of the inflammatory system! |
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cortisone and hydrocortison are examples of short/medium/long acting glucocort?
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short
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prednisone, prednisolone, methylpredinisolone, and triamcinolone are examples of short/medium/long acting glucocort?
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medium
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dexamethasone and beta methasone are examples of short/medium/long acting glucocort?
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long
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sone = ________ acting
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short
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nisolone = ________ acting
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medium
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methasone = ________ acting
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long
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hydrocortisone uses
there's alot of them! suck it! |
allergic
air way inflam GI disorder hepatic disease autoimmune derm malignancies allograft reject neuro opthalmologic inflam renal disease sarcoidosis thrombocytopenia spinal cord injury hemolytic anemia |
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hydrocortisone GI AE
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PUD
perforated viscera increased appetite indigestion |
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hydrocortisone CV AE
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htn
thrombotic effects thrombophlebitis |
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hydrocortisone neuro AE
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mood instability
dizziness headache |
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hydrocortisone muscle AE
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fx
arthralgias weakness tendon rupture osteoporosis |
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long term systemic glucocort use endocrine AE
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cushings
hirsuitism glucose intolerance hyperglycemia menstrual irregularities hypothalamus pituitary adreal axis suppression f |
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long term systemic glucocort use fluid electrolyte AE
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hypocalcemia
sodium/fluid retention hypokalemia |
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long term systemic glucocort use derm AE
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impaired wound healing
acne striae hypopigmentation ecchymosis erythema urticaria |
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misc AE of long term systemic glucocort use
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cataracts, glaucoma
epistaxis diaphoresis fatigue leukocytosis frowth retardation in children |
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your patient is dx with primary adrenal insufficiency. you kow that the problem lies within their...
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adrenal gland
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your patient is dx with 2ndary aadrenal insufficiency. you know that the problem lies within thier..
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pituitary's inability to secrete ACTH
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your patient is dx with tertiary adrenal insufficiency. you know the problem lies within thier..
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hypothalamus. inability to secrete corticotropic releasing hormone
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diagnosis of adrenal insufficiency. how? 2 steps
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1. give corticotropin or cosyntropin
2. measure plasma cortisol 30-60 mins after admin |
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your patient just took a dose of corticotropin in attempt to dx their adrenal disease. labs come back and there has been no rise in plasma cortisol levels. what does this mean?
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it is primary insufficiency
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after labs come back and indicate primary adrenal insufficiency, what is the next step in dx?
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abdominal CT to determine the size of adrenal glands
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how are glucocorticoids absorbed?
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fat soluable
best through GI not a rescue drug metabolized liver excreted urine |
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what is adrenal insufficiency commonly called?
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addisons disease
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what are two main causes of addisons disease?
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autoimmune destruction of adrenal
chronic deficiency of cortisol, aldosterone, and androgens |
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s/s addisons disease
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weakness
fatigue weight loss anorexia arthralgias muscle stiffness apathy salt craving hyperpigmentation hypotension orthostasis scant auxiliary and pubic hair |
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remember...
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these notecards are harder than the test
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treatment of addisons disease
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replacement therapy with drug that has glucocort/mineralcort
hydrocortisone/cortisone pt will need increased dosage during acute stress |
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how should cortisone/hydrocortisone be given for addisons disease? in relation to am/pm
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2/3 in am
1/3 in pm |
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fludrocortisone treatment in addisons disease AE
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dizziess
headache ace rash brusig muscle weakness cataracts |
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adrenal crisis usually occurs with ...
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sudden withdrawl of therapy or stress of a health condition
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s/s adrenal crisis
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hypotesion
diminished cascular tone decreased output inadequate circulatory colume shock cardiac arrest |
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causes of adrenal crisis
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hemmorrhage of adrenal gland
minigicoccal septicemia coumadi use thrombosis of adrenal vein metastasis on adrenal gland |
