Adrenal

Question 1

What’s the weight of a normal adrenal gland?

Answer 1

4gm

Question 2

Name the layers of the adrenal gland from outside to inside.

Answer 2

capsule -> zona glomerulosa -> zona fasciculata -> zona reticularis -> medulla

(zona fasciculata makes up 75% of cortex)

Question 4

What causes weight changes in adrenals?

Answer 4

weight changes due to lipid depletion (causes: weight loss, or prolonged stress)

causes hypertrophy and hyperplasia of the cortical cells which can more than double the weight

Question 5

What are 3 types of steroids produced by adrenal cortex?

Answer 5

glucocorticoids, mineralocorticoids, and sex steroids

Question 6

What does the adrenal medulla make?

Answer 6

chromaffin cell synthesize and secrete catecholamines (epinephrine)

Question 7

What part of adrenal cortex makes glucocorticoids?

Answer 7

zona fasciculata with small contribution from zona reticularis

Question 8

What part of adrenal cortex makes mineralocorticoids (specifically aldosterone)?

Answer 8

zona glomerulosa

Question 9

What part of adrenal cortex makes sex steroids (estrogens and androgens)?

Answer 9

zona reticularis

Question 10

What are 3 hyperadrenal syndromes?

Answer 10

hypercortisolism (Cushing Syndrome- elevation in glucocorticoids)

hyperaldosteronism (hypertension and hypokalemia from sodium retention and potassium excretion

adrenogenital (virilizing syndromes)

Question 11

What are 4 distinctive etiologies of Cushing syndrome?

Answer 11

1. exogenous glucocorticoids (most common of ALL - iatrogenic)

endogenous Cushing syndrome

2. primary hypothalamic-pituitary diseases - hypersecretion of ACTH (most common endogenous)
3. hypersecretion of cortisol by adrenal adenoma, carcinoma, or nodular hyperplasia
4. secretion of ectopic ACTH by nonendocrine neoplasm

Question 12

When Cushing Syndrome is caused by pituitary tumor, it is called…?

Answer 12

Cushing’s disease

Question 13

What’s the etiology of primary hypothalamic-pituatary diseases causing Cushing syndrome?

Answer 13

women> men, in 20s and 30s

Question 14

What are the causes of primary hypothalamic-pituitary diseases?

Answer 14

1. Usually an ACTH-producing microadenoma
2. Corticotroph cell hyperplasia in the anterior pituitary

patients have variable degrees of bilateral nodular adrenal cortical hyperplasia

Question 15

What are the lab levels for primary hypothalamic-pituitary diseases?

Answer 15

high cortisol and high ACTH