Adrenal diseases Flashcards
What does the Adrenal Medulla make and release?
-Catecholamines
What does the adrenal cortex make?
- Steroids such as:
- Mineralcorticoids
- Glucocorticoids
- Sex steroids
What are the features of primary acute (Cortical) insufficiency ?
- Weakness
- Nausea
- Hypoatremia
- Hypotension
- depression
- Skin pigmentation
What causes the skin pigmentation in primary acute cortical insufficiency?
-Get increase of MSH with the ACTH
Primary Addisons disease is cause by what?
-Damage to adrenal cortex and is non-responsive to ACTH
Secondary Addisons disease is caused by what?
-Damage to pituitary gland and reduced ACTH, but cortisol release responsive to ACTH administration
What is the cause of Addison’s disease?
-Autoimmune
What race and gender is Addison’s disease more common in?
-white women
What is secondary adrenocortical insufficiency due to?
-Hypothalamic or pituitary problem
What are the features of Secondary adrenocortical insufficiency?
- No hyper pigmentation
- Hypoglycemia
- Aldosterone usually normally
What can cause an adrenal crisis?
-Massive adrenal hemorrhage causing increased steroid output
What is the relationship between Addison’s disease and infection?
-Infection is increased in addison’s disease
What is the relationship between addison’s disease and the adrenals?
-The adrenals are reduced
What disease is associated with Hypercortisolism?
-Cushing’s disease
T/F Adrenal hypoplasia is a feature of cushing disease
False
-Hyperplasia
The adrenals shrink in Cushings disease because of what?
-Feedback from hypercortisol
What are the symptoms of Cushing disease?
- Moon face
- Osteoporosis
- Buffalo hump
- Obesity
- THin skin
- Amenorrhea
- Muscle weakness
- Poor wound healing
What is the difference between cushing syndrome and cushing disease?
-Cushing syndrome the ACTH is low
What can Cushing disease look like?
-Someone on chronic corticosteroid treatment for chronic major arthritis or other inflammatory diseases
What is usually the result of extended use of exogenous (pharmaceutical) steroids such as prednisone?
-Secondary adrenocortisol insufficiency
In secondary adrenocortisol insufficiency the normal adrenal is suppressed, if treatment is abruptly stopped there is a transient but critical what?
-Hypocortisolic reaction
What is Primary Hyperaldosteronism referred to as?
-Conn Syndrome
In Hyperaldosteronism what happens with Na+ and K+?
- Na+ retention
- K+ secretion
In hyperaldosteronism what happens with the renin-angiotensin system?
-It gets suppressed because there is to much aldosterone
What type of hypertension is found in hyperaldosteronism?
-Secondary hypertension
What percent of Pheochromocytomas are malignant?
10%
T/F Adrenal cortical carinomas are rare
True
What is an adrenal medullary tumor?
-Pheochromocytoma
What does a pheochromocytoma increase?
-Secretion of catecholamines
What do the effects of pheochromocytoma look like>
- Hypertension
- Flushing
- Increased urine catecholamines
What diseases are often associated with pheochromocytoma?
- Neurofibromatosis
- Van Hoppel-Lindau
What is the cause of Paget’s disease of bone (Osteitis Deformans)?
-Unknown but maybe triggered by viral infections
What percent of Caucasians have Paget’s disease of bone?
-3-4%
What age does paget’s disease of bone typically occur?
-Older than 40
T/F Paget’s disease of bone can cause bone pain and fractures
True
What does Pagets disease have to do with phosphates?
-You have high serum alkaline phosphates
What are the common sites of Paget’s disease of bone?
- Vertebrae
- Skull
- Long bones
What does Paget’s disease of bone do to osteoclastic activity?
-Increase with some rebound osteoblastic response
What is the second most frequent bone disease after osteoporosis?
-Paget’s disease of bone
