Adrenal Gland Flashcards
What is the most common cause of Cushing’s syndrome?
Iatrogenic, due to administration of glucocorticoids for therapeutic reasons.
What are the two major types of Cushing’s syndrome?
ACTH-dependent (e.g., pituitary adenoma) and ACTH-independent (e.g., adrenal adenoma).
What is the classic triad of symptoms in Cushing’s syndrome?
Central obesity, hypertension, and glucose intolerance.
What is the first step in diagnosing Cushing’s syndrome?
Exclude exogenous glucocorticoid use and measure 24-hour urinary free cortisol.
What is the most common cause of endogenous Cushing’s syndrome?
Bilateral adrenal hyperplasia due to ACTH hypersecretion (Cushing’s disease).
What is the treatment for Cushing’s disease?
Transsphenoidal surgery to remove the pituitary adenoma.
What is the most common cause of primary hyperaldosteronism?
Aldosterone-producing adrenal adenoma (Conn’s syndrome).
What are the clinical features of primary hyperaldosteronism?
Hypertension, hypokalemia, and metabolic alkalosis.
What is the screening test for primary hyperaldosteronism?
Plasma aldosterone-to-renin ratio (ARR).
What is the treatment for adrenal adenoma causing hyperaldosteronism?
Surgical removal of the adenoma.
What is the most common cause of Addison’s disease?
Autoimmune adrenalitis.
What are the clinical features of Addison’s disease?
Fatigue, weight loss, hyperpigmentation, hypotension, and hyponatremia.
What is the best screening test for adrenal insufficiency?
Cortisol response to ACTH stimulation (cosyntropin test).
What is the treatment for Addison’s disease?
Glucocorticoid (hydrocortisone) and mineralocorticoid (fludrocortisone) replacement.
What is the most common cause of pheochromocytoma?
Sporadic, but 25-33% are associated with inherited syndromes like MEN 2 or VHL.
What is the classic triad of symptoms in pheochromocytoma?
Episodic headache, palpitations, and profuse sweating.
What is the first step in diagnosing pheochromocytoma?
Measurement of plasma or urinary metanephrines.
What is the treatment for pheochromocytoma?
Surgical removal after preoperative alpha-blockade (e.g., phenoxybenzamine).
What is the most common cause of adrenal insufficiency in developing countries?
Tuberculosis.
What is the most common cause of adrenal crisis?
Acute stress (e.g., infection, surgery) in a patient with adrenal insufficiency.
What is the most common cause of secondary hyperaldosteronism?
Renal artery stenosis.
What is the most common cause of adrenal hemorrhage?
Anticoagulation therapy or sepsis (Waterhouse-Friderichsen syndrome).
What is the most common cause of adrenal incidentaloma?
Nonfunctioning adrenal adenoma.
What is the most common cause of congenital adrenal hyperplasia?
21-hydroxylase deficiency.
