Exam 3 Adrenal Hormones

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What is the outer layer of the adrenal cortex called?
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Cortex
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What is the inner layer of the adrenal cortex called?
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Medulla
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Where are the adrenal glands located?
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On top of each kidney
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List the 3 hormones associated with the Medulla
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Epinephrine
Norepinephrine
Dopamine
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List the 3-4 hormones associated with the cortex
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Mineralocorticoids/Aldosterone
Glucocorticoids/Cortisol
DHEAS/Androgens (Testosterone & Estriol)
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What is another name for:
Mineralocorticoids
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Aldosterone
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What is another name for:
Glucocorticoids
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Cortisol
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The adrenal cortex produces steroid hormones from what type of precursor?
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Cholesterol
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Aldosterone is controlled by what system?
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RAA System (RAS)
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Aldosterone is controlled in response to decreased levels of what?
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BP or Blood Volume
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What is associated with the following:
BP, Na & K regulation
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Aldosterone
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What is associated with the following:
Glucose, fat, & protein regulation
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Cortisol
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What is associated with the following:
DHEAS, Testosterone
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Androgens
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What is critical for Na, K, Acid-Base Balance, & BP
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Aldosterone
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What is the cause of Primary HYPERaldosteronism?
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Adrenal tumors
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What is the cause of Secondary HYPERaldosteronism?
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Defects in RAA System
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In Hypertension, what chemical element is Increased?
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Sodium
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In Hypokalemia, what 2 chemical elements are Decreased?
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Potassium
Hydrogen
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What disorder are the following symptoms associated with:
Fatigue, muscle weakness, metabolic alkalosis
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Hypokalemia
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What does Too much DHEAS in kids lead to?
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Precocious puberty, hair growth, and early development of secondary male sex characteristics in boys
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What does Too much DHEAS in women lead to?
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Hirsuitism, acne, male pattern baldness, amenorrhea, masculine traits
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What does Too much DHEAS in men lead to?
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Infertility
Feminizing affects
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What are 2 causes of Too much DHEAS in women?
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Endocrine Disease
Anabolic steroid use
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True or False:
DHEAS is NOT controlled by ACTH
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True
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True or False:
Cortisol is regulated in response to ACTH from Anterior Pituitary
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True
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What does Cortisol increase?
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Fat and protein breakdown
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What hormone is critical to glucose metabolism?
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Cortisol
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What does Cortisol control?
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Sodium, water, and other electrolytes
BP
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What does Cortisol suppress?
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Inflammatory and allergic reactions
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During times of _____, Cortisol has an effect on heart function
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Stress
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When is Cortisol Highest?
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8 a.m.
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When is Cortisol Lowest?
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8-10 p.m.
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What Disease is associated with HYPOcortisolism?
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Addison’s Disease
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What Disease is associated with HYPERcortisolism?
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Cushing’s Syndrome
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What is Addison’s Disease / HYPOcortisolism usually due to?
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Destruction of gland
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The following are consistent with which disease:
Autoimmune, TB, HIV, or fungi
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Addison’s Disease
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HYPOcortisolism – Low Sodium and Low Glucose = ?
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Weakness, fatigue, weight loss
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HYPOcortisolism will have low amounts of what?
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Sodium
Glucose
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HYPOcortisolism will have high amounts of what?
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Potassium
ACTH
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Is skin pigmentation associated with HYPOcortisolism / Addison’s Disease?
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Yes
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HYPERcortisolism – what will cause the following:
Increased Cortisol
Decreased ACTH
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Cortisol-Secreting tumor in the adrenal gland
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HYPERcortisolism – what will cause the following:
Increased Cortisol
Increased ACTH
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ACTH-Secreting tumor in the pituitary
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Is the following considered primary or secondary:
Cortisol-Secreting tumor in the adrenal gland
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Primary
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Is the following considered primary or secondary:
ACTH-Secreting tumor in the pituitary
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Secondary
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Is the following considered primary or secondary:
Prolonged steroid use
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Secondary
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True or False:
HYPERcortisolism alters resistance to stress and inflammation
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True
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True or False:
HYPERcortisolism slows wound healing; inhibiting antibodies
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True
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What does HYPERcortisolism Increase in the blood?
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fatty acids
blood sugar
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What does HYPERcortisolism Decrease?
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Calcium Absorption
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True or False:
With HYPERcortisolism, no diurnal variation is seen
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True
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What does Increased Fatty Acids in the blood lead to?
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Trunk obesity
Moon face
Buffalo Hump
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What does Increased Blood Sugar lead to?
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Obesity
Hyperglycemia
Polydipsia
Glycosuria
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What does Decreased Calcium Absorption lead to?
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Osteoporosis
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What is the following associated with:
Thinning skin with discoloration, striae, and bruising
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HYPERcortisolism
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What are 2 tests that you can run for HYPERcortisolism?
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ACH Levels
24 Hour Urine Cortisol
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Define “The Full Monty”
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Over-production of all adrenal cortex hormones
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The following are consistent with too much what?
Hyperglycemia
Moon Face
Buffalo Hump
Central Obesity
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Cortisol
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The following are consistent with too much what?
Dehydration
Thirst
Increased Sodium
Increased BP
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Aldosterone
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The following are consistent with too much what?
Amenorrhea & Hirsuitism in women
Muscular hypertrophy in young kids
Infertility in males
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Androgens
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As Sodium Rises, with too much aldosterone, what happens to Potassium?
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Falls
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As Sodium Rises and Potassium falls, with too much aldosterone, what happens?
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Muscle Weakness
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What controls the Adrenal Medulla?
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Nervous system
Body’s response to stress, emotion, physical activity, and low glucose levels
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What does the Adrenal Medulla produce?
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Catecholamines
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What are the 3 Catecholamines produced in the Adrenal Medulla?
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Dopamine
Norepinephrine
Epinephrine
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What does Norepinephrine cause in response to a decrease in BP?
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Vasoconstriction of small vessels
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Norepinephrine causes Vasoconstriction of small vessels in response to a Decrease in what?
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Blood Pressure
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Norepinephrine causes Vasoconstriction of small vessels in response to a Decrease or Increase in Blood Pressure?
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Decrease
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Epinephrine mobilizes energy stores to do what?
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Raise Blood Glucose Levels
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What does Epinephrine Increase?
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Heart Rate
Respiration
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What is secreted in HIGH levels during stress or fear?
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Epinephrine
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What is considered the “Fight or Flight” Hormone?
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Epinephrine
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What type of production does Epinephrine have?
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RAPID
20 seconds
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What type of effect does Epinephrine have?
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Only lasts 1-2 minutes
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Hyperactivity of catecholamines may be caused by what?
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Emotions/Stress
Drugs
Food
Tumors
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Dopamine –> Norepinephrine –> Epinephrine –> Metanephrine –> ?
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Vanillylmandelic Acid (VMA)
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Dopamine –> Norepinephrine –> Normetanephrine –> ?
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Vanillylmandelic Acid (VMA)
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Define Pheochromocytoma
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Catecholamine producing tumor
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What lab tests do you perform on Pheochromocytoma?
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Urinary Metanephrines
VMA
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True or False:
Pheochromocytoma – Measuring serum catecholamines is LESS reliable due to short half-life and because levels will be NORMAL between spells
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True
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“Spells” of what are associated with Pheochromocytoma?
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Hypertension
Headache
Dizziness
Pallor
Sweating
Abdominal Pain
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List the hormones made in the adrenal cortex:
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cortisol, aldosterone, androgens
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List the hormones made in the adrenal medulla:
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catecholamines (dopamine, epinephrine, norepi.)
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Name the precursor substance for ALL the adrenal cortex hormones.
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Cholesterol
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What primary mechanism controls aldosterone production?
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RAA System
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what substance does RAA cause to be absorbed in the tubules?
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Sodium Reabsoption
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At what time of day are cortisol levels highest?
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AM
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At what time of day are cortisol levels lowest?
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PM
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What hormone is the primary regulator of cortisol?
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ACTH from the pituitary gland
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List three causes of Cushing’s syndrome.
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Adrenal tumor (primary)
Pituitary tumor (secondary)
Excess cortisol administration (secondary)
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Indicate if the following results will be Increased, Decreased, or Normal in Cushing’s:
Na:
K:
Glucose:
Calcium:
Fatty Acids:
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Sodium: high
Potassium: low
Glucose: high
Calcium: low
Fatty acids: high
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What is the result of excess androgens in women?
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Amenorrhea, hirsuitism, virilization
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List the catecholamines produced by the adrenal medulla
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Dopamine, epinephrine, norepinephrine
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Which hormone from the medulla serves to raise BP, respiration, and blood sugar?
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Epinephrine
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List the catecholamine metabolites that are most frequently tested for in urine
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VMA
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Name the type of tumor associated with catecholamine excesses
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Pheochromacytoma

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