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Endo/Repro Exam 2 > Adrenal Pathology > Flashcards

Adrenal Pathology Flashcards

1
Q

What are the adrenocortical hyperfunctioning diseases?

A 
Hypercortisolism (Cushing)
Hyperaldosteronism
Adrenogenital syndromes (Virilization)
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2
Q

What are the adrenocortical hypofunctioning disease?

A

Primary acute adrenocortical insufficiency
Primary chronic adrenocortical insufficiency
Secondary adrenocortical insufficiency

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3
Q

What are the two types of hypercortisolism?

A

Exogenous

Endogenous

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4
Q

Two types of endogenous hypercortisolism?

A

ACTH-dependent

ACTH-independent

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5
Q

What is hypercortisolism also know as?

A

Cushing syndrome

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6
Q

What occurs to the adrenal gland in exogenous Cushing syndrome and why?

A

Adrenocortical atrophy
The exogenous glucocorticoids are inhibiting ACTH release and therefore the adrenal cortex is not creating glucocorticoids and wastes away

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7
Q

What is endogenous ACTH-dependent Cushing syndrome?

A

ACTH driven cortisol production

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8
Q

What are potential causes of ACTH-dependent Cushing syndrome?

A 
Pituitary adenoma
Ectopic ACTH (small cell lung carcinoma)
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9
Q

What is a pituitary adenoma causing hypercortisolism called?

A

Cushing disease

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10
Q

What causes ACTH-independent hypercortisolism?

A

Autonomous cortisol production

Adrenocortical neoplasms

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11
Q

What occurs to the size of the adrenal glands in ACTH-independent hypercortisolism?

A

Contralateral adrenal gland atrophy due to the affected adrenal gland creating cortisol which then inhibits ACTH release

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12
Q

Do adenomas or carcinomas of the adrenal gland cause more cortisol production?

A

Carcinomas

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13
Q

What occurs to the diurnal pattern of serum cortisol in Cushing syndrome?

A

Loss of the diurnal pattern

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14
Q

What is seen in the urine of Cushing syndrome patients?

A

Urinary excretion of 17-hydroxycorticosteroids

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15
Q

What does dexamethasone (DXM) do?

A

Inhibits release of ACTH from pituitary

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16
Q

What are the expected values of ACTH when low and high does of DXM are administered to a Cushing disease patient?

A

Low: no change
High: decrease ACTH release

17
Q

What occurs in primary hyperaldosteronism?

A

Autonomous overproduction of aldosterone

18
Q

What is the status of renin in hyperaldosteronism?

A

Decreased plasma renin levels

19
Q

Three causes of primary hyperaldosteronism:

A
  1. ) Bilateral idiopathic hyperaldosteronism
  2. ) Aldosterone-producing adenoma
  3. ) Glucocorticoid-remediable hyperaldosteronism
20
Q

What is Conn syndrome?

A

Aldosterone producing adenoma

21
Q

What causes glucocorticoid-remediable hyperaldosteronism?

A

Familial genetics that causes aldosterone synthase to be responsive to ACTH when it typically is not; this means that ACTH will cause an increase in aldosterone and aldosterone does not feedback to inhibit ACTH

22
Q

How is glucocorticoid-remediable hyperaldosteronism treated?

A

Glucocorticoids
DXM
Both will inhibit release of ACTH from pituitary gland

23
Q

Two primary causes of excess adrenal androgens:

A
  1. ) Adrenocortical neoplasms

2. ) Congenital adrenal hyperplasia

24
Q

Why does mixed syndrome occur with adrenocortical neoplasms?

A

Because they are often caused by adenomas which are grow into the basement membrane into other zones of the adrenal gland and cause hypercortisolism

25
Q

What is seen with adrenocortical neoplasms?

A

Decreased ACTH and hypercortisolism

26
Q

Most common cause of congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

27
Q

What is seen in CAH?

A

Increased ACTH
Increased androgens
Decreased glucocorticoids

28
Q

What is primary chronic adrenocortical insufficiency known as?

A

Addison disease

29
Q

What causes primary acute adrenocortical insufficiency?

A

Rapid withdrawal of exogenous steroids

Massive bilateral adrenal hemorrhage

30
Q

What is a disseminated bacterial infection to the adrenal glands known as?

A

Waterhouse-Friderichsen syndrome

31
Q

What bacteria typically cause Waterhouse-Friderichsen syndrome?

A

Neisseria mengitides

32
Q

What can cause primary chronic adrenocortical insufficiency?

A

Autoimmune adrenalitis
Tuberculosis
AIDS: CMV
Metastatic cancers

33
Q

What does POMC stand for?

A

Pro-opiomelanocortin

34
Q

What is POMC?

A

A precursor that is cleaved into ACTH and MSH

35
Q

What does MSH cause?

A

Increase in pigmentation

36
Q

What is the relationship between potassium and sodium in the kidneys?

A

They are found in inverse relations since they are both cationic if sodium is secreted then potassium is absorbed

37
Q

Why does skin hyperpigmentation not occur in secondary adrenocortical insufficiency?

A

Because ACTH is not secreted therefore MSH is not either

Endo/Repro Exam 2 (18 decks)

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