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23 Cards in this Set
- Front
- Back
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Adrenal cortex hormones affect multiple physiologic process including? 4
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1. maintenance of glucose availabiltiy
2. regulation of water and electrolyte balance 3. development of sexual characteristics 4. life saving responses to stress |
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What are the two most common forms of adrenocortical dysfunction and their causation?
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1. Cushing's syndrome, caused by adrenal hormone excess
2. Addison's disease, caused by adrenal hormone deficiency |
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What are the three classes of steroid hormones?
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1.Glucocortiods
2.Mineralcortiods 3.Androgens |
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What 7 things are Glucocorticoids involved with?
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1.Carbohydrate metabolism
2.Protein metabolism 3.Fat metabolism 4.Cardiovascular System 5.Skeletal muscle 6.Central nervous system and mood 7.Stress and respiratory system in neonates |
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1. What do mineralocorticoids do?
2. Which is the most important? |
1. influence renal processing of sodium, potassium, and hydrogen
2.adosterone-most important |
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Explain the physiologic effects of aldosterone?
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Aldosterone acts on collecting ducts of nephron to promote sodium reabsorption in exchange for secretion of potassium and hydrogen; water reabsorbed with sodium
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What are the 3 causes of Cushing's syndrome?
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1.Hypersecretion of adrenocorticotropic hormone (ACTH)
2.Hypersecretion of glucocorticoids 3.Administering glucocorticoids in large doses |
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What is the clinical presentation of Cushings? 5
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1.Obesity
2.Hyperglycemia 3.Glucosuria 4.Hypertension 5.Fluid and electrolyte disturbances |
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What are the treatment options for Cushings?
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1.Sugical removal of the adrenal gland
2.Replacement therapy 3.Irradiation of pituitary gland -often Ketoconazole is also given to inhibit glucocorticoid synthesis |
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What are the causes/ presentations of Addison's disease?
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1.weakness
2.emaciation 3.hypoglycemia 4.Increased pigmentation of the skin and mucous membranes |
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What is the treatment for Addison's?
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1.Replacement therapy with adrenocorticoids
2.Hydrocotisone is the drug of choice |
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1.What does secondary adrenocortical
insuffeciancy result from? 2.What does tertiary adrenocortical insuffeciancy result from? 3.What is diminished? |
1.Secondary results from decreased secretion of ACTH
2.1.Secondary results from decreased secretion of CRH 3.Adrenal secretion of glucocorticoids is diminished |
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What are the clinical presentions of secondary and tertiary adrenocortical insufficiency?
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1.Hypoglycemia
2.Malaise 3.Loss of appetite 4.Reduced capacity to respond to stress |
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What are the clinical presentations of Acute Adrenal Insufficiency? (adrenal crisis)5
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1.Hypotension
2.Dehydration 3.Weakness 4.Lethargy 5.GI symptoms |
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What are the causes of Acute Adrenal Insufficiency? (adrenal crisis)3
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1.Adrenal failure
2.Pituitary failure 3.Inadequate doses of corticosteroids |
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What are the treatments of Acute Adrenal Insufficiency? (adrenal crisis)
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1.Rapid replacement of fluid, salt, and glucocorticoids
2.Glucose |
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1.Hydrocortisone is a ____?
2.It's theraputic uses are? |
1.Synthetic steroid
2.Adrenal insufficiecy -allergic reactions, inflammation and treatment for cancer |
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What are the adverse effects of Hydrocortisone?
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-Low doses show no adverse effects
-Large doses can be highly toxic with: Adrenal suppression Cushing's syndrome |
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What is Fludrocortisone (Florinef)?
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A potent mineralocorticoid with significant glucocorticoid activity.
-It is the only mineralocorticoid available |
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What are the theraputic uses of Fludrocortisone (Florinef)?
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1.Addison's disease
2.Primary hypaldosteronism 3.Congenital adrenal hyperplasia |
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What are the adverse effects of Fludrocortisone (Florinef)?
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1.Hypertension
2.Edema/retention of water and salt 3.Cardiac enlargement |
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What is Dexamethasone?
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A synthetic steroid. Dexamethasone has pronounced glucocorticoid properties with little mineralocorticoid activity?
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1.What does Dexamethasone treat?
2.How should Dexamethasone be administered? |
1.Treats nonendocrine disorders and for diagnostic testing
2.For overnight suppression and test for Cushings give 1mg before 11pm and then measure cortisol before 8am -Normal is suppression of ACTH -Cushing's is little or no suppression; but this is not the best method of determining Cushing's |
