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HRM - Pathology > Adrenal Pathology > Flashcards

Adrenal Pathology Flashcards

1
Q

What three disorders of the adrenal gland cause too much hormones?

A

Cushing syndrome
Hyperaldosteronism
Adrenogenital syndrome

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2
Q

What tests are used to diagnose Cushing Syndrome?

A

24 hour urine free cortisol
Loss of normal diurnal cortisol secretion
ACTH level
Dexamethasone suppression test

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3
Q

What is the most common cause of Cushing syndrome?

A

Iatrogenic Cushing

Drugs caused

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4
Q

What do Cortisol/ACTH tests look like for Iatrogenic Cushing Syndrome?

A

Increased Cortisol

Decreased ACTH

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5
Q

What is the most common endogenous cause of Cushing syndrome?

A

Cushing Disease

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6
Q

What do Cortisol/ACTH levels look like for Cushing Disease?

A

Cortisol increased

ACTH increased

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7
Q

What happens to cortisol levels with a high-dose dexa test in Cushing disease?

A

Supresses

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8
Q

What are causes of adrenal cushing syndrome?

A

Adenoma, hyperplasia, carcinoma

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9
Q

What are Cortisol/ACTH levels for Adrenal Cushing Syndrome?

A

Increased cortisol

Decreased ACTH

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10
Q

What happens to cortisol levels with a high-dose dexa test in Adrenal cushing syndrome?

A

No suppression

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11
Q

What is the most common cause of paraneoplastic cushing syndrome?

A

SCC of the lung

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12
Q

What are Cortisol/ACTH levels for paraneoplastic Cushing syndrome?

A 
Increased cortisol
Increased ACTH (fake)
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13
Q

What happens to cortisol levels with a high-dose dexa test in paraneoplastic Cushing syndrome?

A

No suppression

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14
Q

What are the main effects of aldosterone?

A

Retain Na and H2O

Pee out K

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15
Q

What are symptoms of hyperaldosteronism?

A

Hypertension

Hypokalemia (weakness, fatigue, psychosis)

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16
Q

What are common lab findings of primary hyperaldosteronism?

A 
Elevated Aldosterone
Low Renin
Hypernatremia
Hypokalemia
Metabolic alkalosis
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17
Q

What are the most common causes of primary hyperaldonism?

A 
Cortical adenoma (Conn Syndrome)
Cortical hyperplasia
18
Q

What are the common causes of secondary hyperaldosteronism?

A

Anything that increases renin
CHF\
Decreased renal blood flow
Renin producing tumors

19
Q

What are the lab findings of secondary hyperaldosteronism?

A

Same as primary with HIGH renin

20
Q

If you have a patient with SUDDEN virilization, what is likely the problem?

A

Adrenocortical carcinoma

21
Q

What does adrenocortical carcinoma look like grossly?

A

Necrotic, ugly tumor

22
Q

What’s the prognosis like for adrenocortical carcinoma?

A

Bad.

23
Q

What’s the most common cause of congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

24
Q

What is the result of 21 hydroxylase deficiency?

A

Decreased cortisol and aldosterone

Increased sex steroids

25
Q

What is Addison disease?

A

Primary chronic adrenal insufficiency

26
Q

What is the cause of Addison disease?

A

Usually autoimmune

27
Q

What are symptoms of Addison disease?

A

Weakness, fatigue, GI complaints
Hypotension
Skin hyperpigmentation

28
Q

What are causes of primary acute adrenal insufficiency?

A

Addisonian crisis
Rapid steroid withdrawal
Massive adrenal hemorrhage

29
Q

When do you see massive adrenal hemorrhage?

A

Neisseria infection in an infant

30
Q

What is Waterhouse-Friderichsen syndrome?

A

The neisseria infection of an infant

31
Q

What does Waterhouse Friderichsen syndrome look like?

A

Hypotension, shock
DIC
Massive bilateral adrenal hemorr.
Rapidly progressive

32
Q

What are the most common causes of secondary adrenal insufficiency?

A

Pituitary or hypothalmic insufficiency

Tumor, infection, radiation, infarction

33
Q

What does secondary adrenal insufficiency look like?

A

Symptoms of decreased cortisol and decreased sex steroids

Mineralocorticoids normal because Renin axis is intact

34
Q

What are the 10%’s of a Pheochromocytoma?

A 
10% extra-adrenal
10% bilateral
10% (or more) familial
10% malignant
10% don't have hypertension
35
Q

What is a pheochromocytoma?

A

Neoplasm of catecholamine producing cells

36
Q

What do you look for in the urine if you suspect pheochromocytoma?

A

Catecholamines
VMA
Metanephrines

37
Q

What are symptoms of pheochromocytoma?

A 
Pressure (BP inc)
Pain (Headache)
Perspiration
Palpitations (tachy)
Pallor
Paroxysms
38
Q

More copies of this gene cause a worse prognosis in neuroblastoma.

A

N-myc

39
Q

Who commonly gets neuroblastomas?

A

children

40
Q

What are often seen on slide examination for neuroblastomas?

A

Homer-wright rosettes

HRM - Pathology (10 decks)

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