adrenal Flashcards
For the adrenal hyperfunction disorders, describe the major associated disease, clinical features and expected lab findings For the adrenal hypofunction disorders, describe its clinical features, causes and expect laboratory findings Describe the clinicopathologic features of pheochromocytoma and adrenal adenomas
cushings is too much
cortisol
most common reason for too much body-produced cortisol
ACTH secreting tumor of pituitary
non-glandular reason for too much cortisol
paraneoplastic ACTH from tumor (small cell lung cancer)
adrenal findings in pituitary or paraneoplastic cushings
bilateral cortical atrophy
adrenal finding in endogenous cushings
nodular hyperplasia
most common reason for cushings
iatrogenic
adrenal findings in iatrogenic cushings
total adrenal atrophy
lab values of adrenal cushings
high cortisol.low ACTH
crooke hylaline change
normal granular basophilic cytoplasm of pituitary replaced with homogenous lightly basophilic material
adrenal glands with yellows tumors surrounded by capsules
adenomas
large non-capsulated adrenal tumors
carcinomas
increased levels of plasma renin a sign of
secondary hyperaldosterinism
can cause secondary hyperaldosterinism
decreased renal perfusion
hypovomenia
pregnency
decreased plasma renin a sign of
primary hyperaldosterinism
spirolactone bodies
aldosterone-producting adenomas
eosinophilic laminated cytoplasmic inclusions
spirolactone bodies
DOC of hyperaldosternoism
spirolactone
clincial hallmark of hyperaldosteronism
high bloood pressure
long term effects of hyperaldosteronism
LV hypertrophy, hypokalemia
enzyme deficiency in congenital adrenal hyperplasia
12-hydroxylase
masculinization in females, precocious puberty in makes, salt wasting and hypotension
congenital adrenal hyperplasia
causes of acute adrenal insuffciency
massive adrenal cortex
waterhouse-freiderichsen syndrome
sudden wd of long-term corticosteroid therapy
sress in pts with underlying chronic adrenal insuffciencu
causes of chronic adrenal insuffciency
autoimmune adrenalitis
TB
AIDS
metastatic disease
chronic adrenalcortical insufficiency name
addison disease
most common cause of addison
autoimmune (APS1)h
hyperpigmentatio is in
primary addison disease
GI disturbances, weight loss, hyperpigmentation, hyperkalemia, hyponatermia, volume depletion and hypotension
primary addison disease
low cortiso and androgen and normal aldosterone
secondary hypoadrenalism
intractable vomiting, abdominal pain, hypotension, coma and vascular collapse
acute adrenal crisis
infections, including TB and AIDS can cuase
chronic hypoadrenalism
syndromes associated with adrenal cortical carcinomas
li-fraumeni and beckwith-wiedemann
porrly demarcated lesions with necrosis, hemorrage and cystic change
adrenocortical carcinomas
adrenal cancers invade the:
adrenal vein, vena cave and lymphatics
icubation of tissue with potassium dicromate turns it dark brown
pheo
zellballen nests
pheo
small nets of granular cells highlihted by silver stain
pheo
definitive dx of pheo malignancy made by
mets
clinical feature of pheo
abrupt spike in hypertension, tachycardia, palps, headache, sweating, tremor, apprehension
risks of pheo
MI, HF, renal injury, CVA
lab dx of pheo
increased urinary catecholamines
