Adrenal path Flashcards
What is the primary cause of hyperaldosteronism?
Conn syndrome
get HTN, hypokalemia, metabolic alkalosis
use spironolactone, eplerenone, surgical resection to treat
What is the usual cause of secondary hyperaldosteronism?
Renal Artery Stenosis
decreased blood flow, renin increases b/c thinks low BP
What is Waterhouse Friedrichsen syndrome?
cause of 1* adrenal insufficiency
from N. meningitidis infection–>DIC
get adrenal hemorrhage
what is the treatment for addison’s?
glucocorticoid
fludrocortisone–mineralcorticoid
**only type of adrenal insufficiency that has both low cortisol and low aldosterone
Which forms of adrenal insufficiency show skin pigmentation?
only primary
also the only one w/ messed up aldosterone, w/ high ACTH, w/ any hypotension issues
What is the usual cause of 3* adrenal insufficiency?
decreased CRH from hypothalamus
after abrupt cessation of exogenous glucocorticoids
What is the origin of a neuroblastoma?
neural crest cells
happens along sympathetic trunk
usually adrenal gland
seen in children! Adrenal medulla. mass can cross midline unlike Wilm’s tumor
What is an important histo marker of neuroblastoma?
Homer-Wright Rosettes
What are some important lab/genetic markers of neuroblastoma?
increased HVA and MVA in urine
Bombesin and Neuron specific enolase +
N-myc oncogene
What is the rule of 10s/90s for pheochromocytoma?
90% benign 90% unilateral 90% adrenal medulla 90% don't calcify 90% adults
What are the 5Ps of pheochromocytoma?
Pressure (BP up episodically) Pain (HA) Perspiration (diaphoresis) Palpitations (tachycardia) Pallor
What is the main lab marker for pheochromocytoma?
metanephrines in urine and plasma
Which conditions is pheochromocytoma associated with?
NF1
MEN2A
MEN2B
Von Hippel Lindau disease
What is the treatment for pheochromocytoma?
alpha blockers (nonspecific, irreversible)–>phenoxybenzamine
then beta blocker
surgical resection
What are some EPO secreting tumorS?
Pheochromocytoma
Renal Cell Carcinoma
Hemangioblastoma
Hepatocellular Carcinoma
