ADRENOCORTICAL DYSFXN Flashcards
What are the main disorders of adrenocortical function?
Adrenocortical hyperfunction and adrenocortical hypofunction.
What is the main cause of Cushing’s disease?
Pituitary tumor leading to excess ACTH secretion.
What are the common clinical features of Cushing’s syndrome?
Hypertension, moon face, buffalo hump, truncal obesity, skin thinning, purple striae, and hyperglycemia.
What are the main biochemical findings in Cushing’s syndrome?
Hyperglycemia, hypernatremia, hypokalemia, and elevated serum cortisol.
What is the overnight dexamethasone suppression test used for?
To assess cortisol suppression; failure indicates Cushing’s syndrome.
What distinguishes primary from secondary adrenocortical insufficiency?
Primary shows high ACTH and low cortisol; secondary shows low ACTH and low cortisol.
What are the main features of Addison’s disease?
Dehydration, hypotension, hyperpigmentation, hypoglycemia, and fatigue.
What is the common cause of secondary adrenal insufficiency?
Long-term corticosteroid therapy causing suppression of the HPA axis.
What is congenital adrenal hyperplasia (CAH)?
An inherited metabolic disorder caused by enzyme deficiencies in steroid hormone synthesis.
What is the most common enzyme deficiency in CAH?
21α-hydroxylase deficiency.
What are the key biochemical changes in adrenal insufficiency?
Hyponatremia, hyperkalemia, low cortisol, and metabolic acidosis.
How is CAH diagnosed?
Elevated 17-hydroxyprogesterone levels in plasma or urine.
What are the treatments for CAH?
Glucocorticoids (e.g., cortisol) and mineralocorticoids as needed.
What clinical feature distinguishes primary from secondary adrenal insufficiency?
Hyperpigmentation in primary adrenal insufficiency due to high ACTH levels.
What is the purpose of the short synacthen test?
To assess adrenal cortex response to ACTH.
