ADRENAL Flashcards

1
Q

Two causes of Conn’s syndrome

A

Increased aldosterone
75% unilateral adenoma
25% bilateral hyperplasia

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2
Q

Tx of bilateral adrenal hyperplasia

A

Spironolactone + CCB

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3
Q

Tx of unilateral adenoma causing Conn’s

A

Resection

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4
Q

Waterhouse Friedrickson

A

Adrenal hemorrhage with meningococcal sepsis

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5
Q

Cushing’s disease - most commonly due to?

A

80% of non iatrogenic causes are due to pituitary micro adenoma causing increased ACTH

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6
Q

What is a “medical adrenalectomy”

A

Metryapone and aminoglutethimide

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7
Q

Regardless of size, an adrenal mass should be removed if :

A

Functioning
Growing
OR
Suspicious (brighter) on T2 MRI

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8
Q

Remove adrenal mass lesions greater than …

A

4-6 cm since there is a 15% chance of malignancy if > 6 cm. The risk increases with size.

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9
Q

How does cortisol affect intravascular volume?

A

Positive chronotropic and inotropic effects on heart and helps maintain BP by stimulation angiotensin release and inhibiting synthesis of prostaglandin I2, a potent vasodilator

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10
Q

How do glucocorticoids retard wound healing

A

Decrease IL-2 production and release and lymphocyte activation, as well as making PMNs less responsive and less efficient for chemotaxis and phagocytosis

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11
Q

Where does aldosterone act

A

Distal convoluted tubule –reabsorb sodium and indirectly free water, and to excrete K and H

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12
Q

Feedback loop involving cortico tropic releasing hormone

A

Hypothalamus releases CRH – > delivered to anterior pituitary and pituitary releases ACTH –> adrenal glands synthesize/ please cortisol.

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13
Q

Pheochromocytoma : best screening test

A

Measurement of 24 hr urinary metanephrines due to very high specificity and sensitivity.

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14
Q

MEN I

A

prolactinoma
parathyroid (HYPERPLASIA, not adenoma!)
pancreas (gastronoma)

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15
Q

Tx of MEN I should start with ..

A

Treatment of hyperparathyroidism. Since it’s hyperplasia, you have to do all 4 glands with auto implantation.

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