Adrenal Defects

Question 1

Distinguish between Cushing’s syndrome and Cushing’s disease.

Answer 1

Cushing’s syndrome - chronic exposure to cortisol

Cushing’s disease - benign pituitary adenoma secreting ACTH

Question 2

What is Adrenal Cushing’s?

Answer 2

Adrenal tumour -> excess cortisol

Question 3

What is Addison’s disease?

Answer 3

Chronic adrenal insufficiency.

Question 4

What is addisonian crisis?

Answer 4

Life threatening condition due to adrenal insufficiency caused by and increased stressor.

Question 5

Describe how the dynamic function test using dexamethasone works.

Answer 5

Suppresses ACTH and cortisol secretion

If suppressed by >50% - characteristic of Cushing’s disease

Question 6

Describe how the Synacthen dynamic fucntion test works.

Answer 6

Syncathen - usually increases plasma cortisol by >200nm

If this occurs Addison’s disease can be excluded

Question 7

What is the most common enzyme affected by congenital adrenal hyperplasia?

Answer 7

21-hydroxylase

Question 8

Give some associated symptoms with phaeochromocytomas.

Answer 8

Diaphoresis 
Palpitations
Anxiety 
Weight loss
Hypertension 
Hyperglycaemia