CABS- Endocrine HTN Flashcards

1
Q

3 main adrenal gland causes of HTN

A

pheochromocytoma
primary aldosteronism (Conn’s)
cushing syndrome

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2
Q

thyroid causes of HTN

A

hyperthyroidism

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3
Q

pituitary causes of HTN

A

acromegaly
cushing disease

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4
Q

tumor that arises from Chromaffin cells of adrenal medulla

A

pheochromocytoma

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5
Q

pt presents with HA, sweating, palpitations, HTN, anxiety, feeling of impending death

A

pheochromocytoma

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6
Q

first 2 steps to diagnose pheochromocytoma

A

urine metanephrine
plasma metanephrine

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7
Q

MRI w/ I-MIBG +/or Ga-DOTATE scan to diagnose what (adrenal or extradrenal)

A

pheochromocytoma

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8
Q

first line to treat pheochromocytoma (alpha blocker)

A

phenoxybenzamine

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9
Q

2nd line to treat pheochromocytoma

A

metoprolol

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10
Q

how to definitively treat pheochromocytoma

A

surgery

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11
Q

end product of epi and NE

A

VMA

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12
Q

epi into _____ by MAO enzyme

A

metanephrine

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13
Q

NE into ___ by MAO enzyme

A

normetanephrine

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14
Q

why epinephrine-secreting pheochromocytomas are almost exclusively localized to adrenal medulla?

A

b/c adrenal medulla is only tissue to normally produce large amounts of epi due to presence of PNMT

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15
Q

crucial enzyme for turning norepinephrine into epinephrine

A

PNMT

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16
Q

not used as initial antihypertensive agent in pheochromocytoma b/c it can cause intraoperative HTN

A

Labetolol

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17
Q

more of a beta blocker than alpha blocker

18
Q

____ can increase blood glucose by inhibiting insulin secretion via alpha2 agonism in beta cells

A

catecholamines

19
Q

too much cortisol in Cushing saturates ______ which then allows it to bind and create apparent mineralocorticoid excess (causing hypokalemia and hypernatremia)

A

11beta-HSD2

20
Q

normal plasma ____ at 8AM is 5-23 microgram/mL

21
Q

increase in ACTH and cortisol and responds to dexamethasone

A

Cushing Disease (ACTH-producing pituitary adenoma)

22
Q

increase in CRH, ACTH, and cortisol

A

pseudo-Cushing (depression/anxiety)

23
Q

increase in cortisol and decrease in ACTH; has little effect from dexamethasone

A

adrenal tumor

24
Q

increase in ACTH and cortisol; doesn’t respond to dexamethasone

A

ectopic ACTH/CRH

25
urine free cortisol>3x above normal
cushing
26
midnight plasma cortisol>7.5
cushing
27
overnight high dose dexamethasone; cortisol at 8 AM >1.8
cushing syndrome
28
synthetic steroid that reduces cortisol levels by binding to same receptor as cortisol and decreases amount of ACTH released by pituitary gland
dexamethasone
29
______ works at high doses to suppress ACTH producing pituitary adenoma
dexamethasone
30
stress will ______ secretion of CRH from cell to stimulate ACTH and then cortisol
increase
31
normal or increased ACTH when measured (what differentials)
Cushing disease (ACTH-producing pituitary adenoma) pseudo-Cushing ectopic ACTH/CRH
32
decreased ACTH when measured (what differentials)
adrenal tumor iatrogenic cushing
33
CRH and high dose DST +
Cushing Disease
34
CRH and high dose DST -
Ectopic ACTH/CRH
35
HTN + hypokalemia + metabolic alkalosis
Primary Aldosteronism (Conn's)
36
to measure and diagnose Conn's
increased PAC (aldosterone) decreased PRA (renin)
37
to measure and diagnose secondary hyperaldosteronism
elevated PAC and PRA
38
confirmatory test for primary aldosteronism (Conn's)
oral salt loading (NaCl); increased NaCl, decreased renin, increased aldosterone
39
24 hour urinary aldosterone excretion >12micrograms
Conn's
40
vitamin deficiency in pt with pheochromocytoma
vitamin C (dopamine into NE; tryptophan into serotonin)
41
in MEN I, the most common secretory product of pancreatic and duodenal endocrine lesions
gastrin
42
blocks alpha1 in VSMC blocks beta1 in juxtaglomerular cells (inhibits renin) blocks beta1 in SA node
Labetolol