Adrenal Path Flashcards
General and locational characteristics of the adrenal glands
Retroperitoneal, superomedial to the kidneys, each weighs 4-5 grams
Three layers of cortex are
Zona Glomerulosa- mineralocorticoids- aldosterone
Zona Folliculosa- glucocoricoids- Cortisol
Zona Reticularis- Sex hormones
Medulla produces
Epinephrine and noreepinephrine
Origin of the cortex
mesoderm
origin of the medulla
neuroectodermal
Adrenal shape is determined by?
configuration of the surrounding organs
Cushing syndrome’s most basic cause
Excess Cortisol!!!
Cushing syndrome appearance
moon fascies, buffalo hump, truncal obesity, edema, hypertension, bruisability, hunger, gastric ulcers, thin skin
Know how to differentiate Cushing’s Disease from Cushing’s Syndrome
ok
Hyperaldosteronism by itself is most commonly due to what?
An aldosterone secreting cortical adenoma
What do you call an Aldosterone secreting Cortical Adenoma
CONN SYNDROME
Conn Syndrome characterized clinically by?
hypertension and hypokalemia…because aldosterone increases Na reabsorption but decreases K
Adrenogenital syndrome is what
When there is some difficulty synthesizing cortisol which causes a lack of feedback inhibition to the hypothalamus and pituitary leading eventually to adrenal hyperplasia and increased synthesis of androgens like testosterone
What are the two enzymes most frequently deficient in Androgenital syndrome?
21-hydroxylase or 11-beta-hydroxylase
21 hydroxylase has what effect on sodium?
wastes it
11-beta-hydroxylase has what effect on sodium?
retains sodium
Acute Adrenal insufficiency is what
A FUCKING NIGHTMARE
prototype acute adrenal insufficiency?
Waterhouse Friderichsen Syndrome
What is WFS
Overwhelming sepsis leading to DIC Hypotension Shock Acute Adrenal failure
What is the most common cause of WFS
N. Meningitidis
Other causes of acute adrenal insufficiency
sudden withdrawal of exogenous corticosteroids
Chronic Adrenal Insufficiency is known as
Addison’s Disease
Addisonian pts have what symptoms
weakness, nausea, wt loss, hypotension
What is a good sign that adrenal insufficiency is primary
High ATCH, demonstrated by hyperpigmentation
Common for addison’s disease pts to die suddenly
yes
What is severe in post-menopausal women with Addison’s
Osteoporosis due to lack of adrenals
Most common causes of Addison’s Disease
autoimmune adrenalitis, hemochromatosis
Two possible neoplasms in the adrenal cortex are?
- Adrenal cortical adenoma
- Adrenal cortical carcinoma
Two possible neoplasms in the medulla are?
- Neuroblastoma
- Pheochromocytoma
Adrenal Cortical Adenoma
usually silent
If an adrenal cortical adenoma is functional, the gland adjacent and opposite to it is?
atrophic…..if the adenoma is non-functional, the gland opposite is normal
Adrenal cortical carcinoma
rare. over 90% are functioning
What dimensions make an adrenal cortical carcinoma a likely candidate for metastasis
greater than 5cm or over 50grams
Cortical neoplasms are what color
YELLOW»>KNOW
Most common extracranial tumor of childhood is
Neuroblastoma
Most common site of a neuroblastoma
adrenals and paraaortic ganglia…may occur anywhere in SNS
Appearance (gross) of a neuroblastoma
Red in the center with a thin yellow capsule surrounding it
Pheochromocytoma
the 10% neoplasms 10% are: -familial -extradrenal -bilateral -malignant -in childhood
Adrenals are a common form of metastsis from:
lung, breast, others
multifocal and bilateral = metastatic
