Adrenal stuff Flashcards
What is the difference between Cushing syndrome and Cushing disease?
– Cushing’s Syndrome is primary hypercortisolism - a symptom complex reflecting excessive exposure of tissues to cortisol or corticosteroids
– Cushing’s Disease is secondary hypercortisolism - the specific disorder associated with excess ACTH production
What are four clinical manifestations of Cushing syndrome?
Thin Skin
Striae
Hirsutism
Supraclavicular fat-pad filling
What is the most common etiology of Cushing syndrome?
• Exogenous – or iatrogenic. Prednisone, hydrocortisone, dexamethasone…
What would the following cause?
- Adrenal adenoma
- Adrenal carcinoma
- Adrenal hyperplasia
Cushing syndrome
What are the clinical manifestations of adrenal insufficiency?
- Weakness and fatigue – 100%
- Anorexia – 100%
- Nausea - ~50%
- Muscle, joint, abdominal pain - ~10%
- Postural dizziness - ~10%
Which type of adrenal insufficiency is more common, ACTH-dependent or ACTH-independent?
ACTH-independent.
Mostly autoimmune destruction of adrenal gland, but also HIV, TB cancer
What is the most common cause of adrenal insufficiency?
Iatrogenic. Giving corticosteroids, HPAA axis gets suppressed, remove corticosteroids.
What are the laboratory manifestations of adrenal insufficiency?
• Primary adrenal insufficiency results in loss of
both cortisol and aldosterone; secondary
(pituitary, hypothalamic) isolates cortisol.
~hyponatremia
~hypokalemia
~hypoglycemia
~eosinophilia
What is happening in Addison disease?
~Primary adrenal insufficiency (ACTH-independent)
~Adrenal gland dysfunction or destruction
~increased ACTH (due to lack of suppression by cortisol)
What skin manifestation is seen in Addison disease?
hyperpigmentation of scars, creases, buccal mucosa
What is the therapy for adrenal insufficiency?
~hydrocortisone
~for primary adrenal insufficiency, fludrocortisone to replace aldosterone
