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14 Cards in this Set
- Front
- Back
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Adrenal cortex |
Embryology - mesoderm
GFR ACE |
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Adrenal medulla |
Embryology - neural crest cells
Secrete Catecholamines adrenaline and noradrenaline |
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Adrenal gland blood supply |
Arterial - branches or aorta, renal and inferior phrenic arteries
Venous - inferior vena cave from right adrenal gland and renal vein from left adrenal gland |
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Aldosterone |
Mineralocorticoid steroid hormone - Increases reabsorption of sodium and water by the kidney
- Stimulated secretion of potassium and H+ ions in the kidney
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Congenital adrenal hyperplasia |
Autosomal recessive 90% due to 21 alpha hydroxylase deficiency
10% due to 11 beta hydroxylase deficiency |
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Primary hyperadrenalism |
A problem with the adrenal glands themselves Features: hypokalaemia, suppressed renin activity, high plasma aldosterone
Causes - Conns syndrome aka primary hyperaldosteronism Bilateral adrenal hyperplasia Adrenal carcinoma
Treatment - anti hypertensives, amiloride, surgery |
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Secondary hyperadrenalism |
Causes - renal artery stenosis and renin secreting tumour
Features- increased renin, hypokalaemia and high aldosterone
Treatment - angioplasty re vascularisation and calcium channel blockers |
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Cushing’s syndrome |
Causes: - 65-70% pituitary adenomas - note low cortisol - 20% adrenal adenoma, hyperplasia or carcinoma - low ACTH and high cortisol
- 10-15% ectopic tumours producing ACTH or CRH - high ACTH with no effect on cortisol |
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Primary hypoadrenalism |
Addisons disease - don’t make much adrenal stuff Low aldosterone Hyponatremia Hypoglycaemia Hyperkalaemia High blood urea
Weight loss Hypotension Hyperpigmentation Weakness
Loss of cortisol response to acth short synacthen test and 09:00am cortisol will be low Raised ACTH level
Treatment is hydrocortisone and fludrocortisone for replacement |
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Secondary hypoadrenalism |
Disorders of the hypothalamus or pituitary (irradiation, cancer, infection, infarction)
Test - a rise in cortisol when ACTH is administered Treat the cause |
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Phaeochromocytoma |
Tumour of adrenal medulla 10% bilateral 10% extra renal 10% malignant Tests - raised Catecholamines, 24 hr urinary excretion of VMA, CT\MRI scans for tumour localisation |
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Aldosterone function |
Promotes renal sodium retention and potassium excretion |
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Cortisol |
Promotes protein catabolism |
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The enzyme responsible for converting cholesterol into cortisol in the adrenal cortex is |
11 B hydroxylase |
