Adrenal gland physiology Flashcards
What can cause adrenocortical hyperplasia?
congenital: lack of enzyme for steroid biosynthesis leading to increased androgen production
aquired: pituitary adenomas, small cell lung cancer, bilateral adrenal enlargment
What does diffuse adrenocortical hyperplasia indicate?
it is ACTH driven
What does nodular adrenocortical hyperplasia indicate?
it is ACTH independant
What is the pathological view of an adrenocortical adenoma?
yellow/brown cut surface
How are adrenocortical carcinomas usually found?
due to metastasises
What can cause adrenocortical hypofunction?
Primary - rapid withdrawl of stroid treatment, adrenal haemorrhage, crisis in patient with chronic adrenocorticaal insufficiency
Chronic - Addisons disease, TB, fungal infection, HIV, metastatic
What is the medulla of the adrenals supplied by?
pre-synaptic fibres from the sympathetic nervous system
What cells does the medulla contain? What do they secrete?
chromatin cells
secrete catecholamines
Where do Neuroblastomas sometimes arise from? Where else?
40% adrenal medulla
rest along the sympathetic chain
How do neuroblastomas usually present?
tummy lump in new borns
What is a Phaochromocytoma derived from?
chromaffin cells of the medulla so it secretes catecholamines
What do Phaochromocytomas cause?
secondary hypertenison
Phaochromocytomas are the 10% tumour. What does this mean?
10% are extra adrenal
10% are bilateral
10% are malignant
10% are not associated with hypertension
What is the presentation of Phaochromocytomas?
high blodd pressure headache tachycardia tremours pallor dyspnoea skeletal metastasis
What are the genetics associated with Phaochromocytomas?
MEN2A - sipple syndrome
MEN2B
