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BDS2 BAMS - diseases of human systems > Steroids > Flashcards

Flashcards in Steroids Deck (20)
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1
Q

what are the zones of the adrenal gland and what does each one produce

A

zona glomerulosa - aldosterone
zona fasicularis - cortisol
zona reticularis - adrenal androgens

2
Q

aldosterone (mineralocorticoid)

A
enhances sodium (and water) absorption and promotoes potassium loss 
regulated by RAAS
3
Q

cortisol (glucocorticoid)

A

has physiological affects - lowers immune reactivity, raises BP, inhibits bone synthesis, insulin antagonist
released in response to ACTH from pituitary and regulates itself via a negative feedback loop
(ACTH = adrenocorticotropic hormone)

4
Q

what drugs inhibit aldosterone action

A
ACE inhibitors - (angiotensin converting enzyme) 
AT2 blockers (angiotensin 2 receptor blockers)
5
Q

therapeutic steroids

A

used to suppress adrenal action
often used to suppress inflammatory diseases
glucocorticoid effect = immunosuppresion effect
mineralocorticoid effect = salt and water retention

6
Q

examples of therapeutic steroids

A

hydrocortisone (cortisol equivalent)
prednisolone (4x more potent)
betamethasone (30x more potent)

7
Q

long term adverse effects of therapeutic steroid use

A

hypertension
increased infection risk
osteoporosis
type 2 diabetes

8
Q

cushings syndrome and disease

A

cortisol excess
syndrome = primary failure of cause of medication
disease = secondary failure

9
Q

conns disease

A

aldosterone excess

hypertension

10
Q

signs and symptoms of cushings

A

diabetes mellitus features - thirst, tired, excess urine
poor resistance to infection
centripetal obesity - weight concetnrated in face and trunk
osteoporotic changes
fungal infections

11
Q

why might cushings disease see hyperpigmentation

A

high acth levels (secondary failure) due to gene sequence similarities

12
Q

addisons disease

A

hypofunction of adrenal glands

decreased cortisol and aldosterone

13
Q

sheehans syndrome

A

failure of all pituitary hormones

14
Q

causes of adrenal gland failure that may result in addisons disease?

A

infection
infarction
TB
autoimmune diseses

15
Q

signs and symptoms of addisons disease

A

postural hypotension (aldosterone low)
weight loss and lethargy
hyperpigmentation (only in secondary failure)
symptoms often vague

16
Q

cortisol and ACTH levels for hyperfunction

A

primary failure - high cortisol , low ACTH

secondary failure = high cortisol , high ACTH

17
Q

cortisol and ACTH levels for hypofunction

A

primary - low cortisol, high ACTH

secondary - low cortisol , low ACTH

18
Q

fludrocortisone

A

synthetic aldosterone replacement

19
Q

steroid prophylaxis

A

natural cortisol dose varies with environment e.g increases at physio/psycho logical stresss and infection
increase ptx steroid dose when increases physiologica stress is anticipated e.g infection, surgery

20
Q

dental aspects of steroids

A

steroid prophylaxis may need to be considered for some patients
oral pigmentation in cushings/addisons if secondary cause (ACTH gene similarities)
cushings - candidiasis