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ENRP - Exam 2 > Adrenal Cortex > Flashcards

Adrenal Cortex Flashcards

1
Q

What 3 zones make up the Adrenal Cortex?

A

Zona Glomerulosa
Zona Fasciculata
Zona Reticularis

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2
Q

The Zona Glomerulosa releases?

A

Aldosterone

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3
Q

The Zona Fasciculata releases?

A

Cortisol

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4
Q

The Zona Reticularis releases?

A

Androgens

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5
Q

Primary Adrenal Disease can also cause what syndrome that involves centripetal obesity, moon facies, striae, thin skin and hirsutism?

A

Cushing Syndrome

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6
Q

Primary Hyperadrenalism that is causing increased cortisol is ACTH _____

A

Independent

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7
Q

Secondary Hyperadrenalism that is causing increased cortisol is ACTH _____

A

Dependent

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8
Q

With ACTH Dependent elevated cortisol, what gross finding should you expect?

A

Bilateral cortical hyperplasia of the adrenals

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9
Q

If the Cushing Syndrome is due to a Primary Hyperadrenalism cause like an adrenal tumor, what are the levels of CRH, and results of the dexamethasone suppression test?

A

LOW CRH

– ACTH NOT suppressed

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10
Q

What is Conn’s Syndrome?

A

Primary Hyperaldosteronism

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11
Q

What are the findings with Primary Aldosteronism? (3)

A

Hypertension
Hypokalemia
Hypomagnesemia

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12
Q

If the Hypertension presents at a young age, is very severe or does not respond to treatment, what should you consider?

A

Conn’s Syndrome = Primary Hyperaldosteronism

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13
Q

Where is the problem with Secondary Hyperaldosteronism?

A

RAAS system

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14
Q

If the RAAS system is changed, it can cause secondary hyperaldosteronism. Describe the system cascade.

A
  • Angiotensinogen
    • (+) Renin
  • Angiotensin I
    • (+) ACE Kinase 2
  • Angiotensin II
  • AT1 receptor
  • Aldosterone
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15
Q

What are some possible causes of Secondary Hyperaldosteronism?

A

(RAAS effected)

  • Diuretics
  • Decreased renal perfusion
  • Pregnancy
  • Renin secreting tumors
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16
Q

With Hyperaldosteronism, what should you measure?

A 
PRA = Plasma Renin Activity
PAC = Plasma Aldosterone Concentration
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17
Q

If the PRA and PAC are ELEVATED, what is the diagnosis?

A

Secondary Hyperaldosteronism

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18
Q

If the PRA is LOW but the PAC is HIGH, what is the diagnosis? What should you do next?

A

Primary Hyperaldosteronism

–> Get Adrenal CT to look for Adenoma

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19
Q

What histo item may be present in Aldosterone-Secreting Adenomas? What is the patient at risk for?

A

Spironolactone bodies

–> Ischemic heart disease

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20
Q

What is Congenital Adrenal Hyperplasia?

A

Inherited error of metabolism that results in a defective enzyme needed for steroidogenesis

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21
Q

How is Congenital Adrenal Hyperplasia (CAH) inherited?

A

AR

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22
Q

With Congenital Adrenal Hyperplasia, what is the defective enzyme usually?

A

21 - hydroxylase

23
Q

Of the Adrenal Cortex steroids (aldosterone, cortisol and androgens), which is the one that provides (-) feedback to lower ACTH levels?

24
Q

What is 21-hydroxylase needed to make?

A

Aldosterone
Cortisol

==> Without it = INCREASED ANDROGENs

25
What usually catches Congenital Adrenal Hyperplasia at birth?
Heel stick
26
If you suspect Congenital Adrenal Hyperplasia, what should you measure?
17 - hydroxyprogesterone (precursor for cortisol)
27
Salt Wasting Syndrome levels of 21-hydroxylase?
NONE | -- NO mineral/glucocorticoids (aldosterone/cortisol)
28
What are the 3 findings of Salt Wasting Syndrome?
Hypotension Hyperkalemia Hyponatremia
29
How will females look at birth with Salt Wasting Syndrome?
NO 21-hydroxylase | => Virilization
30
Simple Virilizing Syndrome levels of 21-hydroxylase?
Partial | -- some mineral/glucocorticoids
31
What is the finding with Simple Virilizing Syndrome?
Virilization
32
Nonclassic/late onset adrenal virilism levels of 21-hydroxylase?
Partial
33
What are the findings with Nonclassic/Late onset adrenal virilism?
Precocious puberty with acne and hirsutism
34
What is the treatment for Congenital Adrenal Hyperplasia?
Glucocorticoids (cortisol) | -- also provides the (-) feedback missing in order to decrease ACTH and Androgen production
35
What are the 3 types of CAH?
Salt wasting Syndrome Simple Virilizing Syndrome Nonclassic/Late onset adrenal virilism
36
Primary Adrenocortical Insufficiency is due to?
Loss of cortical cells and deficits in hormone production
37
Secondary Adrenocortical Insufficiency is due to?
HPA axis disease
38
What are some symptoms of Primary ACUTE Adrenocortical Insufficiency?
Hypotension, Hyperkalemia, fever, N/V, abdominal pain
39
Rapid Steroid withdrawal can cause Primary ACUTE Adrenocortical Insufficiency. What occurs?
With steroids = adrenal glands atrophy | -- MUST TAPER steroids otherwise the adrenal glands will not wake up and function
40
Adrenal Hemorrhage can also cause Primary ACUTE Adrenocortical Insufficiency. When is a specific example?
Neisseria Meningitidis causing Waterhouse Friderichsen Syndrome
41
What is Addison Disease?
Primary CHRONIC Adrenocortical IInsufficiency
42
What are the signs of Primary CHRONIC Adrenocortical Insufficiency?
Fatigue Skin hyperpigmentation Joint pain Weight loss
43
Fatigue, weight loss, joint pain and skin hyperpigmentation is what type of Adrenocortical Insufficiency?
Primary CHRONIC
44
What are the 2 most common causes of Primary Chronic Adrenocortical Insufficiency?
Autoimmune | Tuberculosis
45
What is the mutation in with Autoimmune Polyendocrine Syndrome Type 1?
AIRE mutation
46
What are 6 findings with Autoimmune Polyendocrine Syndrome Type 1?
- Adrenalitis - Parathyroiditis - Hypogonadism - Pernicious Anemia - Mucocutaneous Candidiasis - Ectodermal Dystrophy
47
What are 6 findings with Autoimmune Polyendocrine Syndrome Type 1?
- Adrenalitis - Parathyroiditis - Hypogonadism - Pernicious Anemia - Mucocutaneous Candidiasis - Ectodermal Dystrophy
48
Antibodies against _____ and ____ can cause the mucocutaneous candidiasis seen with Autoimmune Polyendocrine Syndrome Type 1
IL-17 and IL-22
49
What are 3 findings seen with Autoimmune Polyendocrine Syndrome Type 2?
- Adrenalitis - Thyroiditis - Type 1 DM
50
What are 3 findings seen with Autoimmune Polyendocrine Syndrome Type 2?
- Adrenalitis - Thyroiditis - Type 1 DM
51
With what type of Adrenal Cortical Neoplasia will you seen Virilization?
Carcinoma
52
Which is larger - Adrenal Cortical Carcinoma or Adenoma?
Carcinoma
53
What symptom is present with an Adrenal Cortical Carcinoma that is not present with an Adenoma?
Virilization
54
Both Adrenal Cortical Carcinomas and Adenomas are?
Incidental | Functional

ENRP - Exam 2 (21 decks)

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