adrenal cases Flashcards
which zone of adrenals makes cortisol?
fasiculata
drainage route of adrenals?
○ LEFT - into the left renal vein
○ RIGHT - directly into the IVC
what is Schmidt’s syndrome?
The co-existence of Primary Hypothyroidism and Addison’s Disease
○ This patient has antibodies against their thyroid gland and their adrenal glands
Tests for Addison’s ?
Synacthen test
how is synacthen test administered?
and monitored?
IM injection
check cortisol at 30 and 60 minutes
what hormones made in adrenal medulla?
adrenaline
noradrenaline
what hormones made in adrenal zone glomerulosa? (cortex)
aldosterone
what hormones made in adrenal zone reticularis?
androgens
Conns would produce a tumour exactly where?
adrenals
zona glomerulosa
bcos makes excess aldosterone
Phaeochrmocytoma would produce a tumour exactly where?
adrenal medulla
treatment for phao’s?
Urgent alpha blockade with phenoxybenzamine.* or doxazosin
Add beta blockade.
Finally arrange surgery.
test for cushings?
low dose dex
2nd most common cause of cushings?
adrenal adenoma (10%)
what is the diagnostic work up if suspecting Cushings?
LD Dex
Inferior Petrosal SS
Confirm with MRI (in prep for surgery)
in the synacthen test, how much acth to give and what is the expect result for cortisol?
• Administer 250 µg synthetic ACTH
○ Normal people should be able to produce MORE than 550 nM of cortisol within 30 mins
