Adrenal Gland Pathology Flashcards
What are the layers of the adrenal cortex?
Zona glomerulosa, zona fasciculata, zona reticularis (GFR)
Which hormone does the zona glomerulosa secrete?
Aldosterone
Which hormone does the zona fasciculata secrete?
Cortisol
Which hormones does the zona reticularis secrete?
Weak androgens (sex hormones)
What are the causes of ACTH independent Cushing’s syndrome?
Adrenal adenoma/adrenal cancer or bilateral adrenal hyperplasia (will have low ACTH levels)
What are the causes of ACTH dependent Cushing’s syndrome?
Pituitary tumor (Cushing’s dz) or ectopic ACTH producing tumor (ACTH levels will be high)
What is the presentation of adrenocortical insufficiency with lack of corticosteroids?
Vague malaise, N/V, hypoglycemia, refractory hypotension
What is the presentation of adrenocortical insufficiency with lack of mineralocorticoids?
Hyperkalemia and hyponatremia
What are the manifestations of chronic adrenal insufficiency?
Mucous membrane pigmentation, skin pigmentation, darkening of hair, vitiligo, loss of pubic and axillary hair, wt loss/emaciation, muscular weakness, fingernails may show linear bands of darkening
What is the MCC of primary chronic adrenocortical insufficiency at the time of initial description?
TB
What is the MCC of primary chronic adrenocortical insufficiency in developed countries and worldwide?
Auto immune
What is the adrenal medulla comprised of?
Chromaffin cells deriving from the neural crest
What is the function of the adrenal medulla?
Responsible for catecholamine secretion (NE and E); under sympathetic control
What should be prophylactically removed in those with MEN 2A and B?
Thyroid due to increased risk of medullary thyroid carcinoma
What is the pineal gland comprised of?
Photoreceptor containing neural tissue; it is responsible for melatonin secretion
