16 - Adrenal Glands (part 2) Flashcards
Clinical manifestations include: abnormal fat distribution (truncal obesity, striae, cervical fat pad, and moon face), hypokalemia, cardiac arrhythmias, muscle weakness, weight gain, edema, and increased susceptibility to infection.
Cushing Syndrome
In order to diagnose, the ACTH stimulation test is used. Primary = ↑ ACTH and ↓ Cortisol. If it is secondary, there will be ↓ or normal ACTH and a gradual ↑ in Cortisol.
Addison’s Disease
Clinical manifestations are acute and unpredictable. Can last for seconds to hours, and symptoms are abrupt and subside slowly.
Paroxysmal Pheochromocytoma
Clinical manifestations include: hyponatremia, hyperkalemia, dehydration, hypotension, hypoglycemia, weakness, fatigue, dark pigmentation of oral mucosa and skin, & decreased axillary and pubic hair.
Addison’s Disease
Adrenal medulla hyperfunction.
Pheochromocytoma
Excessive androgen secretion (adrenogenital syndrome).
Congenital Adrenal Hyperplasia
Diagnostic findings for this condition include vanillymandelic acid, free catecholamines, and metanephrine.
Paroxysmal Pheochromocytoma
Glucocorticoid oversecretion (hyperfunction).
Primary is caused by Cortisol-secreting adrenal tumors (benign or malignant).
Secondary is caused by an ACTH secreting tumor (pituitary or hypothalamus).
Cushing Syndrome
iatrogenic = overdosage of glucocorticoids
Clinical manifestations include headache, diaphoresis, and palpitations (triad of symptoms).
Pheochromocytoma
Chronic primary adrenocortical insufficiency.
Addison’s Disease
Lab values include:
- ↑ plasma cortisol and urinary cortisol secretion
- ↑ blood glucose
- ↑ sodium
- ↓ potassium
- Plasma ACTH
Cushing Syndrome
Lab values include:
- ↑ sodium and water
- ↓ potassium
- Polyuria
- Polydipsia
- Metabolic alkalosis
- No overt edema
- ↑ plasma and urine aldosterone level
- Plasma renin level
Hyperaldosteronism
Clinical manifestations include:
- Adult females
- Hirsutism
- Balding
- Breast atrophy
- Masculine body build
- Female infants
- Masculinization of external genitalia
- Adult males
- Not so dramatic
- Boys may develop secondary sex characteristics early
Congenital Adrenal Hyperplasia
In order to diagnose, the ACTH suppression test is used. Administer dexamethasone, and check for cortisol levels. If the cortisol levels rise, the person is positive for this condition.
Cushing Syndrome
Lab values include:
- ↓ aldosterone level
- ↓ cortisol level
- hypoglycemia
- hyponatremia
- hyperkalemia
- ↑ BUN
- ↑ hematocrit.
Addison’s Disease
Primary form of this condition is known as Conn’s Syndrome, and is caused by an adrenal tumor (typically benign).
Secondary form of this condition is caused by alteration in RAAS, renal artery disease, and/or cardiac failure.
Hyperaldosteronism
