Adrenal causes of hypertension Flashcards
Layers of the adrenal glands
Outer - glomerulosa
Middle - fasciculata
Inner - reticularis
Primary hyperaldosteronism
Zona glomerulosa
- adenoma
- hyperplasia
Who to screen for primary hyperaldosteronism
Hypokalaemia
Resistant hypertension (3 drugs)
Younger people
Initial screening fot primary hyperaldosteronism
Suppressed renin
Normal/ high aldosterone
Confirmatory tests for primary hyperaldosteronism
Oral or IV Na+ suppression test
Treatment for unilateral adenoma
Laprascopic adrenalectomy
Medical treatment (sometimes)
Treatment for bilateral hyperplasia
Medical treatment (aldosterone antagonist)
- spironolactone
- eplerinone
Phaeochromocytoma
Tumour of the adrenal medulla
Products of the adrenal medulla
Catecholamines
- dopamine
- norepinephrine
- epinephrine
Adrenomedullin
Peptide associated with phaeochromocytoma
Gene located on chromosome 11
Positive influence in hypertension, MI, COPD
Biological effects of noradrenaline
Acts on alpha 1 and 2
Vasoconstriction
- increased BP
- pallor
Glycogenolysis
Biological effects of adrenaline
Vasoconstriction
Vasodilation in muscle
Increased heart rate
Sweating
Presentation of phaeochromocytoma
Spells
- headache, sweating
- pallor, palpitation
- anxiety
Hypertension
- permanent
- intermittent
Family history
AD conditions associated with phaechromocytoma
Neurofibromatosis type 1
Multiple endocrine neoplasia type 2
Von Hippel- Lindau syndrome
Neurofibroma
Tumour under the skin
