Adrenal

Question 1

normal adrenal - where are things made

Answer 1

cortex (outside) –> medulla (inside)

zona glomerulosa: aldosterone

zone fasciculata: cortisol

zona reticularis: sex steroids

Question 2

what is the most common neoplasm of the adrenal cortex?

Answer 2

adrenal cortical adenoma

Question 3

pheo is usually a tumor in which part of the adrenals

Answer 3

medulla

Question 4

Answer 4

autoimmune adrenalitis

• adrenal gland shrinks
• lymphs, macrophages, adrenal cell death, adrenal cortical cells

Question 5

Answer 5

waterhouse-friderichsen syndrome: adrenal cortical hemorrhage due to shock

Question 6

causes of primary adrenal insufficiency

Answer 6

autoimmune adrenalitis (80%)

adrenal hemorrhage

TB

amyloidosis

cancer

CAH

Question 7

secondary adrenal insufficiency - water balance

Answer 7

low ACTH –> JUST CORTISOL DEFICIENCY

hypotension from impaired CV function –> water retention.

• normal K, hyponatremia

+ no hyperpigmentation

Question 8

primary adrenal insufficiency - water balance

Answer 8

destruction of both glomerulosa and fasciculata –> low cortisol and aldosterone

Hypotension w/ hyperkalemia and hyponatremia

Question 9

clinical features w/ highest positive predictive value for Cushings

Answer 9

• proximal muscle weakness and atrophy
• osteoporosis (in men and pre-menopausal women)
• spontaneous bruising
• unexplained hypokalemia