Adrenal Flashcards
Layers of adrenal gland and what they produce
Glomerulosa- mineralocorticoids
Fasciculata- glucocorticoids
Reticularis- sex hormones
Adrenal medulla- adrenaline and noradrenaline
What is Schmidts Syndrome
Addison’s disease and primary hypothyroidism occuring together
Causes of Addisons disease
Autoimmune, TB ,Tumour mets Adrenal haemorrhage (meningococcus) Amyloidosis
Symptoms of Addisons
↑K ↓ Na+ + ↓glucose Postural hypotension Skin pigmentation Lethargy Depression
Investigations of Addisons
SynACTHen test
Check cortisol at 30 and 60 mins
Treatment of Addisons
Hormone replacement – hydrocortisone/ fludrocortisone if primary adrenal lesion
Causes of Cushings syndrome
ACTH dependent: (↑ACTH) • Pituitary tumour – “Cushing’s disease” (85%) • Ectopic ACTH- producing tumour (5%) (small cell lung cancer, carcinoid tumour)
ACTH independent:
• Adrenal adenoma/cancer (10%), adrenal nodular hyperplasia, iatrogenic steroid use
Symptoms of Cushings
Moon face Buffalo hump Striae
Acne Hypertension Diabetes Muscle weakness (proximal myopathy) Hirsutism
Investigation of Cushings
1st line: Overnight dexamethasone suppression test or 24h urinary free cortisol
Treatment of Cushings
Treat underlying cause, e.g removal of tumour
Cause of Conns syndrome
Adrenal tumour
Symptoms of Conns
Uncontrollable hypertension ↑ Na+
↓ K+
Investigation of Conns
Raised Aldosterone:Renin Ratio
Treatment of Conns
Aldosterone antagonists/potassium sparing diuretics – Spironolactone, eplerenone, amiloride
Phaechromocytoma casues
Adrenal medullary tumour that secretes adrenaline
