Adrenal Disorders Flash Cards

Question 1

Where are the adrenal glands located?

Answer 1

Above each kidney.

Question 2

What are the two regions of the adrenal gland?

Answer 2

Adrenal cortex and adrenal medulla.

Question 3

What hormones are produced by the adrenal medulla?

Answer 3

Epinephrine and norepinephrine.

Question 4

What hormones are produced by the adrenal cortex?

Answer 4

Cortisol, aldosterone, and androgens.

Question 5

What are the three zones of the adrenal cortex?

Answer 5

Zona glomerulosa (aldosterone), zona fasciculata (cortisol), zona reticularis (androgens).

Question 6

What controls cortisol secretion?

Answer 6

The hypothalamic-pituitary-adrenal (HPA) axis via CRH and ACTH.

Question 7

What is the role of aldosterone?

Answer 7

Regulates sodium retention, potassium excretion, and blood pressure.

Question 8

What is the most common cause of Cushing’s syndrome?

Answer 8

Long-term steroid therapy (exogenous cause).

Question 9

What are the clinical features of Cushing’s syndrome?

Answer 9

Moon face, buffalo hump, weight gain, muscle weakness, hypertension, and hyperglycemia.

Question 10

What is Addison’s disease?

Answer 10

Primary adrenal insufficiency due to destruction of the adrenal cortex.

Question 11

What are common causes of Addison’s disease?

Answer 11

Autoimmune destruction, tuberculosis, metastatic cancer, fungal infections, amyloidosis.

Question 12

What are symptoms of Addison’s disease?

Answer 12

Fatigue, weight loss, hyperpigmentation, hypotension, hyponatremia, hyperkalemia.

Question 13

What is the ACTH stimulation test used for?

Answer 13

Diagnosing adrenal insufficiency by measuring cortisol response to ACTH injection.

Question 14

What is the treatment for Addison’s disease?

Answer 14

Lifelong glucocorticoid and mineralocorticoid replacement (hydrocortisone, fludrocortisone).

Question 15

What is the primary cause of Conn’s syndrome?

Answer 15

Aldosterone-producing adrenal adenoma (primary hyperaldosteronism).

Question 16

What are the effects of excess aldosterone?

Answer 16

Hypertension, hypokalemia, metabolic alkalosis, muscle weakness.

Question 17

How is primary hyperaldosteronism diagnosed?

Answer 17

Plasma aldosterone-to-renin ratio (ARR) and confirmatory saline infusion or oral salt-loading test.

Question 18

What is the treatment for primary hyperaldosteronism?

Answer 18

Surgical removal of adrenal adenoma or medical management with spironolactone.

Question 19

What is pheochromocytoma?

Answer 19

A catecholamine-secreting tumor of the adrenal medulla.

Question 20

What are the classic symptoms of pheochromocytoma?

Answer 20

Paroxysmal hypertension, headache, palpitations, diaphoresis (sweating).

Question 21

How is pheochromocytoma diagnosed?

Answer 21

Plasma metanephrines or 24-hour urinary catecholamines.

Question 22

What is the treatment for pheochromocytoma?

Answer 22

Surgical removal with preoperative alpha-blockade (phenoxybenzamine).

Question 23

What is congenital adrenal hyperplasia (CAH)?

Answer 23

A group of genetic disorders causing enzyme deficiencies in cortisol synthesis.

Question 24

What is the most common enzyme deficiency in CAH?

Answer 24

21-hydroxylase deficiency.

Question 25

What are the symptoms of 21-hydroxylase deficiency?

Answer 25

Ambiguous genitalia in females, salt wasting, hypotension, hyperkalemia.

Question 26

How is CAH diagnosed?

Answer 26

Elevated 17-hydroxyprogesterone levels.

Question 27

What is the treatment for CAH?

Answer 27

Glucocorticoid and mineralocorticoid replacement therapy.

Question 28

What is secondary adrenal insufficiency?

Answer 28

ACTH deficiency leading to reduced cortisol production but normal aldosterone.

Question 29

What is the main cause of secondary adrenal insufficiency?

Answer 29

Prolonged glucocorticoid use leading to HPA axis suppression.

Question 30

What is the difference between Cushing’s disease and Cushing’s syndrome?

Answer 30

Cushing’s disease is due to a pituitary tumor secreting ACTH; Cushing’s syndrome includes all causes of cortisol excess.

Question 31

What is the dexamethasone suppression test used for?

Answer 31

Diagnosing Cushing’s syndrome by testing cortisol suppression with dexamethasone.

Question 32

What imaging is used for adrenal tumors?

Answer 32

CT or MRI of the adrenal glands.

Question 33

What is the most common cause of adrenal incidentalomas?

Answer 33

Non-functional adrenal adenomas.

Question 34

What are signs of adrenal crisis?

Answer 34

Severe hypotension, shock, vomiting, weakness, hypoglycemia.

Question 35

What is the emergency treatment for adrenal crisis?

Answer 35

IV hydrocortisone, fluid resuscitation, and glucose administration.

Question 36

What are the metabolic effects of cortisol?

Answer 36

Increases blood glucose, protein catabolism, and lipolysis; suppresses immune function.

Question 37

What is the function of androgens from the adrenal cortex?

Answer 37

Contribute to secondary sexual characteristics and serve as estrogen precursors.

Question 38

What are the common causes of adrenal calcifications?

Answer 38

Tuberculosis, fungal infections, metastatic disease, hemorrhage.

Question 39

What is the most common adrenal malignancy?

Answer 39

Adrenocortical carcinoma.

Question 40

How is adrenocortical carcinoma treated?

Answer 40

Surgical resection with possible mitotane therapy.

Question 41

What is Nelson’s syndrome?

Answer 41

Pituitary adenoma growth after bilateral adrenalectomy in Cushing’s disease.

Question 42

What is the role of the renin-angiotensin system in adrenal function?

Answer 42

Regulates aldosterone secretion for sodium retention and blood pressure control.

Question 43

How does adrenal insufficiency affect blood pressure?

Answer 43

Causes hypotension due to aldosterone and cortisol deficiency.

Question 44

What is the role of glucocorticoids in inflammation?

Answer 44

Suppress immune responses by inhibiting cytokine production and leukocyte activity.

Question 45

What is a potential side effect of long-term glucocorticoid therapy?

Answer 45

Osteoporosis, muscle wasting, hyperglycemia, and adrenal suppression.

Question 46

What condition is associated with episodic hypertension and pheochromocytoma?

Answer 46

Multiple endocrine neoplasia type 2 (MEN2).

Question 47

What is the typical age of presentation for primary hyperaldosteronism?

Answer 47

30-50 years, more common in women.

Question 48

What condition can cause secondary hyperaldosteronism?

Answer 48

Renal artery stenosis, leading to increased renin secretion.

Question 49

Why must beta-blockers be avoided before alpha-blockers in pheochromocytoma?

Answer 49

Unopposed alpha stimulation can cause hypertensive crisis.

Question 50

What dietary advice is given to Addison’s disease patients?

Answer 50

Increase salt intake, especially in hot weather or during illness.

Question 51

What test is used to differentiate primary from secondary adrenal insufficiency?

Answer 51

ACTH stimulation test and plasma ACTH levels.

Question 52

What are the cardiovascular effects of adrenal insufficiency?

Answer 52

Hypotension, low cardiac output, and risk of shock.

Question 53

What adrenal disorder is commonly seen in critically ill patients?

Answer 53

Relative adrenal insufficiency or critical illness-related corticosteroid insufficiency (CIRCI).