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Endocrinology > Adrenal Path > Flashcards

Adrenal Path Flashcards

1
Q

General and locational characteristics of the adrenal glands

A

Retroperitoneal, superomedial to the kidneys, each weighs 4-5 grams

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2
Q

Three layers of cortex are

A

Zona Glomerulosa- mineralocorticoids- aldosterone
Zona Folliculosa- glucocoricoids- Cortisol
Zona Reticularis- Sex hormones

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3
Q

Medulla produces

A

Epinephrine and noreepinephrine

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4
Q

Origin of the cortex

A

mesoderm

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5
Q

origin of the medulla

A

neuroectodermal

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6
Q

Adrenal shape is determined by?

A

configuration of the surrounding organs

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7
Q

Cushing syndrome’s most basic cause

A

Excess Cortisol!!!

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8
Q

Cushing syndrome appearance

A

moon fascies, buffalo hump, truncal obesity, edema, hypertension, bruisability, hunger, gastric ulcers, thin skin

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9
Q

Know how to differentiate Cushing’s Disease from Cushing’s Syndrome

A

ok

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10
Q

Hyperaldosteronism by itself is most commonly due to what?

A

An aldosterone secreting cortical adenoma

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11
Q

What do you call an Aldosterone secreting Cortical Adenoma

A

CONN SYNDROME

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12
Q

Conn Syndrome characterized clinically by?

A

hypertension and hypokalemia…because aldosterone increases Na reabsorption but decreases K

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13
Q

Adrenogenital syndrome is what

A

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

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14
Q

What are the two enzymes most frequently deficient in Androgenital syndrome?

A

21-hydroxylase or 11-beta-hydroxylase

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15
Q

21 hydroxylase has what effect on sodium?

A

wastes it

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16
Q

11-beta-hydroxylase has what effect on sodium?

A

retains sodium

17
Q

Acute Adrenal insufficiency is what

A

A FUCKING NIGHTMARE

18
Q

prototype acute adrenal insufficiency?

A

Waterhouse Friderichsen Syndrome

19
Q

What is WFS

A 
Overwhelming sepsis leading to 
DIC
Hypotension
Shock
Acute Adrenal failure
20
Q

What is the most common cause of WFS

A

N. Meningitidis

21
Q

Other causes of acute adrenal insufficiency

A

sudden withdrawal of exogenous corticosteroids

22
Q

Chronic Adrenal Insufficiency is known as

A

Addison’s Disease

23
Q

Addisonian pts have what symptoms

A

weakness, nausea, wt loss, hypotension

24
Q

What is a good sign that adrenal insufficiency is primary

A

High ATCH, demonstrated by hyperpigmentation

25
Q

Common for addison’s disease pts to die suddenly

A

yes

26
Q

What is severe in post-menopausal women with Addison’s

A

Osteoporosis due to lack of adrenals

27
Q

Most common causes of Addison’s Disease

A

autoimmune adrenalitis, hemochromatosis

28
Q

Two possible neoplasms in the adrenal cortex are?

A
  • Adrenal cortical adenoma

- Adrenal cortical carcinoma

29
Q

Two possible neoplasms in the medulla are?

A
  • Neuroblastoma

- Pheochromocytoma

30
Q

Adrenal Cortical Adenoma

A

usually silent

31
Q

If an adrenal cortical adenoma is functional, the gland adjacent and opposite to it is?

A

atrophic…..if the adenoma is non-functional, the gland opposite is normal

32
Q

Adrenal cortical carcinoma

A

rare. over 90% are functioning

33
Q

What dimensions make an adrenal cortical carcinoma a likely candidate for metastasis

A

greater than 5cm or over 50grams

34
Q

Cortical neoplasms are what color

A

YELLOW»>KNOW

35
Q

Most common extracranial tumor of childhood is

A

Neuroblastoma

36
Q

Most common site of a neuroblastoma

A

adrenals and paraaortic ganglia…may occur anywhere in SNS

37
Q

Appearance (gross) of a neuroblastoma

A

Red in the center with a thin yellow capsule surrounding it

38
Q

Pheochromocytoma

A 
the 10% neoplasms
10% are:
-familial
-extradrenal
-bilateral
-malignant
-in childhood
39
Q

Adrenals are a common form of metastsis from:

A

lung, breast, others

multifocal and bilateral = metastatic

Endocrinology (33 decks)

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