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1 - MI ENDOCRINOLOGIA > 8 - Distúrbios Adrenais > Flashcards

8 - Distúrbios Adrenais Flashcards

1
Q

ANATOMIA E FISIOLOGIA:

A

hipotámo - CRH
adeno-hipófise - ACTH
córtex-suprarrenal - CORTISOL

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2
Q

REGULAÇÃO - cortisol:

A
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3
Q

REGULAÇÃO - aldosterona:

A
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4
Q

Esteroidogênese no Córtex da Adrenal:

A

hipeplasia adrenal congenita - defienciadaenzima 211betahidroxilase

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5
Q

Distúrbios Adrenais - Etiopatogenia:

A
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6
Q

Etiologia - IAP:

A

Autoimune (maioria dos casos)
Isolada
SPA tipo 1 (Addison, Hipoparatireoidismo, Candidíase mucocutânea)
SPA tipo 2 (Addison, DM1, doença autoimune tireoidiana)

Infecciosa ( prevalência ainda muito relevante no Brasil)
Tuberculose
HIV, CMV
Fúngica ( Criptococose, histoplamose, Paracoccidioidomicose)

Genéticas
Hiperplasia adrenal congênita (virilização, hipocortisolismo, perda de sal)

Outras
Hemorragia suprarrenal bilateral ( sepse, meningococemia)
Metástase
Sarcoidose, amiloidose, hemocromatose
Adrenalectomia bilateral
Drogas (mitotano, etomidato, cetoconazol)

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7
Q

Etiologia - IAS:

A

Tumores selares
Radioterapia
Hipofisite
Apoplexia
Síndrome de Sheehan
Infiltração ( Histiocitose X, Tuberculose, Sarcoidose)
Trauma
Uso exógeno de corticoide!!!

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8
Q

manifestações clínicas:

A
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9
Q

Principal manifestação clínica da IAP:

A

Hiperpigmentação cutânea - CRH (hipot) estimula POMC - hipófise aumenta secreção de ACTH e MSH (causador da hiperpigmentação)

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10
Q

Diagnóstico de insuficiência adrenal:

A

Cortisol matinal < 5 - confirma IA

Cortisol matinal 5-17 - realizar Teste de Cortrosina

Cortisol matinal maior ou igual a 18 exclui IA

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11
Q

Insuficiência adrenal com aumento de ACTH:

A

Insuficiência adrenal primária

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12
Q

Insuficiência adrenal com ACTH normal ou diminuído:

A

Insuficiência Adrenal Central

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1 - MI ENDOCRINOLOGIA (9 decks)

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