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Pathology > Andrenals > Flashcards

Andrenals Flashcards

0
Q

What is the best screening method for phaeochromocytoma’?

A

Urinary total catecholamine level

Metanephrines + Vanilyl mandedic acid

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1
Q

What is phaeochromocytoma’ derived from?

A

Neural crest cells

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2
Q

What is the most common cause of Cushing’s syndrome?

A

Steroid administration

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3
Q

What is Cushing’s disease ?

A

Primary pituitary disease - adenoma ACTH hypersecreation

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4
Q

What is the cause of Conns syndrome?

A

Excessive production of aldosterone

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5
Q

What are the characteristics of Conns syndrome?

A
  1. HTN
  2. Renal damage
  3. Hypokalemic alkalosis
  4. Muscle weakness
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6
Q

What are the causes of Conns syndrome?

A
  1. Adenoma of zona glomerulosa

2. Idiopathic bilateral hyperplasia of zona glomerulosa

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7
Q

Primary hyperaldosteronism?

A
  1. Conn syndrome
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8
Q

Secondary hyperaldosteronism ?

A

(Associated with increased levels of hormones of the RAA system)

  1. Following dehydration
  2. Blood loss
  3. Cardiac and liver failure with 3rd spacing of fluid
  4. Renal artery stenosis
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9
Q

What are the principle causes of adrenal insufficiency ?

A
  1. Autoimmune adrenalitis

2. TB of adrenal glands

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10
Q

What is the most common cause of congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

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11
Q

What drugs are given prior to surgery for phaeochromocytoma?

A
  1. Alpha blockade - phEnoxybenzamine

2. Beta blockade

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12
Q

What is Addison’s disease?

A

Adrenal insufficiency

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13
Q

Ectopic ACTH

A
  1. Oat cell carcinoma
  2. Bronchial carcinoma
  3. Bronchial adenoma
  4. Thymic tumours
  5. Islet cell tumours
  6. MTC
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14
Q

Mineralocorticoid excess

A
  1. Increase BP due to sodium and water retention
  2. Tiredness
  3. Muscle weakness
  4. Thirst
  5. Polyuria/noctuira
  6. Headache
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15
Q

Diagnosing mineralocorticoid excess

A
  1. Increase aldosterone
  2. Increase sodium
  3. Decrease potassium (QT prolongation and U wave)
  4. Decrease plasma renin (due to negative feedback caused by increase BP and aldosterone)
16
Q

Glucocorticoid excess

A
  1. Plasma cortisol levels - increase with loss of diurnal variation
  2. 24hr cortisol levels
  3. Dexamethasone suppression test (no decrease in morning cortisol levels)
  4. Plasma ACTH levels
    Undetectable - primary adrenocortical tumours
    Levels will be suppressed after administration of CRH in Cushing’s disease (but not if ACTH is ectopic)
17
Q

Addison’s disease

A

Adrenocortical hypofunction

  1. AI
  2. Withdrawal of corticosteroid tx
  3. Post adrenelectomy
  4. Drugs - ketoconazole, rifampicin, phenytoin
  5. Infection - tb, hiv
  6. Sarcoid
  7. Water house fredrichson syndrome
  8. Metastatic deposits
  9. Amyloidosis
  10. CAH
  11. Panhypopituitarysm
  12. ACTH deficiency
18
Q

Addison’s diagnostics

A
  1. Low sodium
  2. Low cortisol
  3. High ACTH
  4. Short synacthen test - no increase in cortisol
19
Q

Acute Addison’s

A
  1. Low BP
  2. Hypoglycaemia
  3. Low sodium
  4. Dehydration
20
Q

Chronic Addison’s

A
  1. Anorexia
  2. Decrease postural BP (due to Na and water loss)
  3. WL
  4. Muscle wasting
  5. Circumural skin pigmentation (b/c ACTH)

Pathology (23 decks)

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