Adrenals Flashcards
State the four main causes of Cushing’s syndrome
Pituitary tumour, adrenal tumour, ectopic ACTH-producing tumour, iatrogenic steroid use
What is Cushing’s disease?
Pituitary tumour producing ACTH
Describe the clinical features of Cushing’s syndrome
Moon face, buffalo hump, striae, acne, hypertension, diabetes mellitus, proximal myopathy, hirsutism
What investigations are required to diagnose Cushing’s syndrome?
Low dose dexamethasone suppression test, high dose dexamethasone suppression test
State at least three causes of Addison’s disease
Autoimmune disease, TB, adrenal tumour, metastases, adrenal haemorrhage, amyloidosis
Describe the blood test results in Addison’s disease
Hyperkalaemia, hyponatraemia, hypoglycaemia
Describe the clinical features of Addison’s disease
Postural hypotension, skin pigmentation, lethargy, depression
How is Addison’s disease diagnosed?
SynACTHen test
How is Addison’s disease managed?
Treat cause - if primary adrenal lesion, hormone replacement with hydrocortisone or fludrocortisone
What causes Conn’s syndrome?
Adrenal tumour
Describe the clinical features of Conn’s syndrome
Uncontrollable hypertension
Describe the blood test results in Conn’s syndrome
Hypernatraemia, hypokalaemia, increased aldosterone to renin ratio
What is Conn’s syndrome?
Primary aldosteronism
Describe the management of Conn’s syndrome
Aldosterone antagonists/ potassium sparing diuretics, e.g. spironolactone, eplerenone, amiloride
What is a phaeochromocytoma?
Tumour of the chromaffin cells in the adrenal medulla secreting adrenaline
