Adrenal Glands Flashcards
What are the layers of the adrenal cortex from out to in and what do they secrete
Glomerulosa - Aldosterone
Fasciculata - Cortisol
Reticularis - weak Androgen
What is cushing SYNDROME
Ectopic supply of ACTH or similar substance increasing adrenal secretion of cortisol
What is cushing DISEASE
Pituitary source of high ACTH secretion
What are the gross features of an adrenal cortical adenoma
well circumscribed and yellow ball in one area
this compared to secondary hyperadrenalism which makes the entire cortex hypertrophic
what would occur to the cortisol level if you gave high dose dexamethasone to someone with a pituitary adenoma causing cushing disease
it would be suppressed
what is the classic triad of Primary hyperaldosteronism (Conn’s disease)
HTN
Hypokalemia
Hypomagnesemia
What are the characteristics of an aldosterone secreting adenoma
Small
Young pts
Spironolactone bodies
High incidence of ischemic hear disease
What causes most cases of congenital adrenal hyperplasia
deficiency in 21-hydroxylase
What occurs in salt wasting syndrome
Lack of 21-hydroxylase ->
no salt retention
hyperkalemia
hypotension
how would you classify someone with precocious puberty with acne and hirsutism
late onset adrenal virilism from later 21-hydroxylase deficiency
what is the therapy for congenital adrenal hyperplasia
glucocorticoids
prolonged use of corticosteroids can lead to what effect on adrenals
atrophy
what is the triad of adrenal crisis
Hypotension
Hyponatremia
Hyperkalemia
If a kid with N. meningitidis develops adrenal insufficiency what occurred and what is it called
adrenal hemorrhage
Waterhouse-Friderichsen syndrome
what are signs and symptoms of acute adrenal insufficiency
Hypotension Abd pain Fever N./V Hyponatremia Hypoglycemia
What are the signs and sx of primary chronic adrenocortical insufficiency
Malaise, fatigue
Anorexia and weight loss
Joint pain
Hyperpigmentation of skin
What is nelson syndrome
Someone who has cushing disease and their adrenals removed. keeps ACTH high with no product -> chronic insufficiency
What are the most common causes of primary adrenal insufficiency in the developed world, undeveloped world, and the whole world
Developed and whole world, Autoimmune
Developing, TB
if there is a question about most common cause go autoimmune
Describe Autoimmune polyendocrine syndrome 1
Mutation in AIRE
Adrenalitis Parathyroiditis Hypogonadism Pernicious anemia Candida ECTODERMAL DYSTROPHY
What classifies adrenal cortical carcinoma
Its HUGE and its lumpy >200 gm
List the 10% rule of pheochromocytoma
10% extra-adrenal 10% bilateral 10% in kids 10% malignant 10% NOT associated with HTN
25% are familial
What is the classic triad of pheochromocytoma
Headache
Palpitations
Diaphoresis
How do you diagnose pheochromocytoma
measure catecholamine metabolites in blood and urine
-Normetanephrine/metanephrine
what is a myolipoma
Benign tumor of fat and bone - can bleed
What are the three Ps of MEN1 (germline MEN1 tumor suppressor)
Primary hyperparathyroidism Pancreatic endocrine tumors Pituitary adenomas (lactotroph/somatotroph)
What categorizes MEN 2A (germline GoF in RET proto-onco)
Pheochromocytoma
MEdullary thyroid carcinoma
Parathyroid hyperplasia
What categorizes MEN 2B (point mutation RET proto-onco)
Medullary thyroid carcinoma
Pheochromocytoma
Mucosal Neuromas
Marfanoid body habitus
