CABS- Endocrine HTN Flashcards
3 main adrenal gland causes of HTN
pheochromocytoma
primary aldosteronism (Conn’s)
cushing syndrome
thyroid causes of HTN
hyperthyroidism
pituitary causes of HTN
acromegaly
cushing disease
tumor that arises from Chromaffin cells of adrenal medulla
pheochromocytoma
pt presents with HA, sweating, palpitations, HTN, anxiety, feeling of impending death
pheochromocytoma
first 2 steps to diagnose pheochromocytoma
urine metanephrine
plasma metanephrine
MRI w/ I-MIBG +/or Ga-DOTATE scan to diagnose what (adrenal or extradrenal)
pheochromocytoma
first line to treat pheochromocytoma (alpha blocker)
phenoxybenzamine
2nd line to treat pheochromocytoma
metoprolol
how to definitively treat pheochromocytoma
surgery
end product of epi and NE
VMA
epi into _____ by MAO enzyme
metanephrine
NE into ___ by MAO enzyme
normetanephrine
why epinephrine-secreting pheochromocytomas are almost exclusively localized to adrenal medulla?
b/c adrenal medulla is only tissue to normally produce large amounts of epi due to presence of PNMT
crucial enzyme for turning norepinephrine into epinephrine
PNMT
not used as initial antihypertensive agent in pheochromocytoma b/c it can cause intraoperative HTN
Labetolol
more of a beta blocker than alpha blocker
Labetolol
____ can increase blood glucose by inhibiting insulin secretion via alpha2 agonism in beta cells
catecholamines
too much cortisol in Cushing saturates ______ which then allows it to bind and create apparent mineralocorticoid excess (causing hypokalemia and hypernatremia)
11beta-HSD2
normal plasma ____ at 8AM is 5-23 microgram/mL
cortisol
increase in ACTH and cortisol and responds to dexamethasone
Cushing Disease (ACTH-producing pituitary adenoma)
increase in CRH, ACTH, and cortisol
pseudo-Cushing (depression/anxiety)
increase in cortisol and decrease in ACTH; has little effect from dexamethasone
adrenal tumor
increase in ACTH and cortisol; doesn’t respond to dexamethasone
ectopic ACTH/CRH