Adrenal pathology

Question 1

primary hyperaldosteronism is what

Answer 1

over secretion of aldosterone due to issue with adrenal gland

Question 2

causes of primary aldosteronism

Answer 2

Conn’s syndrome

adenoma

Question 3

what is secondary hyperaldosteronism

Answer 3

over secretion of aldosterone secondary to increased renin

Question 4

causes of secondary hyperaldosteronism

Answer 4

decreased renal perfusion
hypovolaemia
pregnancy

Question 5

what is hypercortisolism + causes

Answer 5

over secretion of cortisol

causes: Cushing’s syndrome or disease, exogenous steroids, extopic ACTH, ACTH secreting pituitary adenoma, adrenal adenoma or carcinoma

Question 6

what is Waterhouse-Friderischen sydnrome

Answer 6

septicaemia infection causing acute hyposecretion of adrenal hormones

Question 7

causes of adrenal hypofunction

Answer 7

acute: rapid withdrawal of steroid treatment, massive adrenal haemorrhage, Waterhouse-Friderischen
chronic: Addison’s disease

Question 8

what is Addison’s disease

Answer 8

adrenal insufficiency due to destruction of adrenal cortex resulting in reduced production of glucocorticoids, mineralocorticoids and adrenal androgens

Question 9

dexomethasone suppression test result and ACTH levels for Cushing’s, adrenocortical tumour secreting cortisol, ectopic ACTH syndrome

Answer 9

Cushing’s: dexo suppresses and ACTH slightly high with loss of circadian rhythm (as issue is high ACTH causing excess cortisol)

adreno tumour: not suppressed, low or undetectable ACTH - as cortisol being secreted independently of ACTH so will lower its production

ectopic ACTH: not suppressed, high ACTH - as high ACTH but not controlled by pituitary so cannot be switched off by cortisol