Adrenal glands (Pathology)

Question 1

3 layers of cortex and what they excrete

Answer 1

glomerulosa - mineralcorticoids “salt”
fasciculata - glucocorticoids “sugar”
reticularis - estrogens and androgens “sex”

Question 2

adrenal medula excretes

Answer 2

Epi & NE

Question 3

trunkal obesity, moon facies w/flushing, acne, buffalo hump

Answer 3

cushing syndrome

Question 4

Cushing disease

Answer 4

pituitary cushing syndrome

Question 5

characteristics of hyperaldosteronism

Answer 5

htn & hypokalemiaa

Question 6

aldosterone-secreting cortical adenoma causes

Answer 6

Conn syndrome

hypertension & hypokalemia

Question 7

usual significance of cortical adenomas?

Answer 7

often insignificant (insidentaloma)

Question 8

21-hydroxylase or 11-beta-hydroxylase deficiency leads to

Answer 8

adrenogenital syndrome

Question 9

adrenogenital syndrome

Answer 9

impaired synthesis of both cortisol and aldosterone

increased secretion of adrenocorticotropic hormone, resulting in adrenal hyperplasia and increased synth of testosterone

Question 10

Most common cause of Waterhouse-Friderichsen Syndrome

Answer 10

N. meningitidis

Question 11

typical appearance of adrenal glands in Waterhouse-Friderichsen syndrome

Answer 11

big bag of blood

Question 12

3 causes of acute adrenal insufficiency and outcome

Answer 12

N. meningitidis in Waterhous-Friderichsen syndrome
Sudden withdrawal from corticosteroids
patients with chronic insufficiency with sudden stress

Often fatal

Question 13

chronic adrenal insufficiency

Answer 13

addison’s disease

Question 14

addison’s disease characteristics

Answer 14

weakness, nausea, weight loss, hypotensive. pigmented skin.
hyponatremia, hyperkalemia, metabolic acidosis, hypoglycemia, low cortisol,

failure to respond to stimulation tests by increasing cortisol output

Question 15

failure to respond to stimulation tests by increasing cortisol output

Answer 15

addison’s disease

Question 16

Other causes of chronic adrenal insufficiency

Answer 16

TB, autoimmune, hemochromatosis

also tumors or suppresion of hypothalamus

Question 17

adrenal cortex neoplasms

Answer 17

adenoma

carcinoma

Question 18

adrenal medulla neoplasms

Answer 18

neuroblastoma

pheochromocytoma

Question 19

adrenal cortical adenoma

Answer 19

most are silent
well circumscribed, 2.5 cm
if functional, opposite gland atrophic
if nonfunctional, opposite gland normal

Question 20

yellow adrenal adenoma

Answer 20

cortical

Question 21

adrenal cortical carcinoma

Answer 21

very uncommon
children or adults
>90% functioning
big ones are malignant
no mitoses, no anaplasia - bland

Question 22

neuroblastoma

Answer 22

most common extracranial solid tumor in children
650/yr in US
adrenals and paraaortic ganglia are most common sites

red tumor, surrounded by a ring in adrenal medulla

Question 23

pheochromocytoma

Answer 23

red tumor surrounded by ring in adrenal medulla

10% neoplasm
episodic htn
histology nonpredictive

Question 24

pheochromocytoma “10% neoplasm” items (5)

Answer 24

familial
extra-adrenal
bilateral
malignant
in childhood

Question 25

paraganglion system

Answer 25

sites of paraganglion cell nests where neoplasms may form. cervical, mediastinum, along aorta, down to iliacs & bladder

Question 26

most common types of adrenal neoplasms

Answer 26

metastatic (lung, breast, many others)

multifocal = usually mets