Acth production by the pituitary gland low baseline

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secondary adrenal insufficiency; however, tumors and hemorrhaging can also interfere w. ACTH production by the pituitary gland. Low baseline Cortisol levels and an elevated ACTH > 200 pg/mL
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Introduction to Hormones/Pituitary Function/Adrenal Function – Objectives 6. Describe the ACTH or Cortisol Stimulation Test and what it’s primarily used for. It’s used in the diagnosis of adrenal insufficiency; A blood draw for baseline cortisol is done (8 am), then cosyntropin or cortrisyn are administered (synthetic stimulators of cortisol, which tests the capacity of the adrenal gland to increase hormone production in response to stimulation), repeat samples are drawn at 30 and 60 mins post stimulation, a stimulated free cortisol level < 18 ug/dL indicates impaired renal fxn 7. Name the hormone primarily affected in Cushing’s syndrome and how it is affected. Also, give a brief definition of Cushing’s syndrome. Cushing’s syndrome describes the array of signs and symptoms resulting from excess glucocorticoid production (inc. cortisol) resulting from excess glucocorticoid production or prolonged exogenous steroid use. The most common causes of Cushing’s syndrome are ACTH-secreting pituitary adenoma (68%); autonomous cortisol production from an adrenal tumor (17%, ACTH is suppressed); and excess ectopic ACTH or CRH production (15%, usually malignant) There would be increased urinary free cortisol and 17 hydroxycorticosteroids Symptoms – HTN, obesity, glucose intolerance, plethoric faces, purple striae, hirsuitism, abnormal menses, muscle weakness Trx: surgery, radiation, glucocorticoid replacement 8. List the hormones released by the anterior pituitary gland (pg 03 table 17-2) and their corresponding hypophysiotropic hormones (pg 402 table 17-1). Indicate whether each of the anterior pituitary hormones are tropic or direct effector hormones - list tissues/organs targeted if direct effector. HYPOPHYSIOTROPIC HORMONES THYROTROPIN RELEASING HORMONE (TRH) – releases TSH and prolactin GONADOTROPIN RELEASING HORMONE (GnRH) – releases LH and FSH CORTICOTROPIN RELEASING HORMONE (CRH) – releases ACTH GROWTH HORMONE RELEASING HORMONE (GHRH) – releases GH STOMATOSTATIN – inhibits GH and TSH releases DOPAMINE – inhibits prolactin release DIRECT EFFECTOR – act directly on peripheral tissue; i.e. Growth hormone (multiple) and prolactin (breasts) TROPIC HORMONE - their actions are specific for another endocrine gland; i.e. LH (gonad), FSH (gonad), TSH (thyroid), and ACTH (adrenal)
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