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SP16- Gen Path Exam 3 > Adrenal Glands (Endocrine System) > Flashcards

Adrenal Glands (Endocrine System) Flashcards

1
Q

The ________ are two triangular-shaped glands located on top of the kidneys.

A

adrenal glands

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2
Q

What do the adrenal glands secrete?

A

hormones and chemicals

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3
Q

Which portion of the adrenal gland produces hormones? Which portion of the adrenal gland produces chemicals (catecholamines)?

A

Cortex (outer portion) = hormones

Medulla (inner portion) = catecholamines

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4
Q

The adrenal cortex produces and secretes _____, _____, _____, and _____.

A 
(the cortex is like a "cape" around the medulla)
C ortisol
A ldosterone
P rogesterone
E strogen
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5
Q

What are the three chemicals produced by the adrenal medulla?

A
  1. Epinephrine
  2. Norepinephrine
  3. Dopamine
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6
Q

Diseases of the adrenal gland typically affect the _____.

A

cortex

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7
Q

What are the two types of hyperadrenalism?

A
  1. Hypercortisolism (Cushing’s Syndrome)
  2. Hyperaldosteronism

(cortisol and aldosterone are the two steroid hormones of the cortex)

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8
Q

What are four possible causes of Hypercortisolism (Cushing’s Syndrome)?

A
  • Excess administrations of exogenous glucocorticoids
  • Primary Adrenal Hyperplasia or neoplasm
  • Primary Pituitary source (microadenoma)
  • Ectopic ACTH secretion by neoplasm

Keep in mind that ACTH tells the adrenal gland to secrete/produce cortisol

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9
Q

What is Cushing Disease?

A

a form of cushing’s syndrome by which a tumor or hyperplasia of the pituitary gland (usually an adenoma) causes excess secretion of ACTH

(remember, adenomas are benign)

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10
Q

What are the short-term clinical features of Cushing’s Syndrome?

A

weight gain
hypertension
Moon Facies (accumulation of fat in the face)
Buffalo Hump (accumulation of fat at the neck/back)

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11
Q

What are the long-term clinical features of Cushing’s Syndrome?

A 
decreased muscle mass (cortisol = breakdown)
diabetes
osteoporosis
cutaneous striae
hirsutism (hair)
mood swings/depression/psychosis
menstrual irregularities
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12
Q

Hyperaldosteronism results in _______ retention and _____ excretion.

A

sodium retention
potassium excretion

(Aldosterone acts in the distal tubules and collecting ducts to increase ions and water in the kidney, thereby increasing blood volume and pressure)

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13
Q

Due to sodium retention associated with hyperaldosteronism a patient will display _________.

A

hypertension

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14
Q

Due to the excessive potassium excretion, a patient with hyperaldosteronism will have _______.

A

hypokalemia

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15
Q

Plasma _____ carries out the conversion of _______, released by the liver, to angiotensin. The RAS system will act to ultimately reabsorb water/sodium and increase blood pressure.

A

renin

angiotensinogen

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16
Q

Primary Hyperaldosteronism (rare) is caused by hyperplasia/neoplasm and shows a(n) ______ in levels of plasma renin.

A

decrease

17
Q

Secondary Hyperaldosteronism is due to activation of the renin-angiotensin system and shows a(n) ______ in levels of plasma renin.

A

increase

18
Q

Hypoadrenalism can be primary or secondary. Secondary hypoadrenalism is due to deficiency of _____ and therefore decreased stimulation of the adrenals.

A

ACTH

19
Q

How does hypoadrenalism manifest?

A 
weakness/fatigue
GI disturbances (anorexia, nausea, vomiting, diarrhea)
20
Q

_________ is a rare but severe condition caused by a sudden defective production of adrenal steroids (cortisol and aldosterone). It represents an emergency/crisis.

A

Acute adrenal insufficiency

21
Q

Primary Chronic Adrenocortical Insufficiency is the progressive destruction of the adrenal cortex due to _____, ______, or ______.

A

an autoimmune process
infection (TB, AIDS)
metastatic disease

22
Q

Primary Chronic Addrenocortical Insufficiency is more well-known as _____.

A

Addison’s Disease

“primary chronic ADDrenocortical = ADD-1-sons”

23
Q

Patients with Addison’s Disease will often show skin/mucosal pigmentation due to an elevation in serum ______.

A

ACTH

[remember that the cortex is destroyed, so it doesn’t respond to ACTH even though it is present in high amounts. MSH (melanin stimulating) is a byproduct of ACTH]

24
Q

What are the clinical features of Addison’s Disease? Does secondary adrenocortical insufficiency have the same clinical symptoms?

A
  • progressive weakness (both)
  • GI disturbances (both)
  • hyperpigmentation (primary only)
  • craving for salt (both)
25
Q

True or False: Addison’s Disease can result in death if not recognized and treated properly.

A

True

26
Q

How is Addison’s Disease treated?

A

corticosteroid replacement therapy

27
Q

What is SECONDARY Adrenocortical Insufficiency?

A

any disorder of the hypothalamus or pituitary that reduces output of ACTH

(primary: cortex is destroyed and wont respond to ACTH)

28
Q

True or False: Secondary Adrenocortical Insufficiency shows skin/mucosa pigmentation similar to Primary Adrenocortical Insufficiency.

A

False

29
Q

______ is an Adrenal Neoplasm (of chromaffin cells) that releases epinephrine and causes persistent or episodic high blood pressure.

A

Pheochromocytoma

30
Q

Pheochromocytoma is more prevalent in ________.

A

Females

PHE = FEmales

31
Q

True or False: Pheochromocytoma is surgically correctable.

A

True

32
Q

Pheochromocytomas are often referred to as the “10% tumor” or as “following the rule of 10.” Why?

A

Pheochromocytomas do everything about 10% of the time:
10% are bilateral
10% are extra-adrenal
10% are malignant (that means most are BENIGN!)
10% are familial (…now believed to be ~25%)

33
Q

______ are tumors of multiple endocrine organs (medullary thyroid carcinoma, parathyroid, pheochromocytoma, pancreas, pituitary, etc).

A

Multiple Endocrine Neoplasia Syndromes (MEN)

  • MEN1
  • MEN2A
  • MEN2B
34
Q

_____ results from a single amino acid substitution in the RET protein that results in activation of RET proto-oncogene–mediated cellular processes.

A

MEN2B

35
Q

Which proto-oncogene is associated with MEN?

A

RET

36
Q

What are the common clinical symptoms of MEN2B?

A
  • mucosal neuromas (collection of nerves on tongue, eyelids, labial commisures, etc)
  • large, blubbery lips
  • Marfanoid body habitus (long/thin legs and arms)
  • Early onset medullary carcinoma of thyroid (remember that medullary thyroid carcinomas are the least common type ~5%. Papillary is most common.)

SP16- Gen Path Exam 3 (12 decks)

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