Chempath 15: Adrenal Disease Flashcards
What are the 3 zones of the adrenal cortex ?
Zona glomerulosa
Zona Fasciculata
Zona Reticularis
In which zone of the adrenal cortex is aldosterone produced ?
Zona Glomerulosa
In which zone of the adrenal cortex is cortisol produced ?
Zona fasciculata
In which zone of the adrenal cortex are androgens such as DHEA produced ?
Zona reticularis
DHEA (dehydroepiandosterone) is a precursor to male and female sex hormones including oestrogen and testosterone
Where is adrenaline produced ?
Adrenal Medulla
List 2 potential causes of hyperplastic Adrenal glands ?
Cushing’s disease Ectopic ACTH (e.g lung tumour)
Where does the Right adrenal gland drain into ?
Inferior vena cava (IVC)
Where does the left adrenal gland drain into ?
Left renal vein
What is schmidt’s syndrome ?
A syndrome of co-existing hypothyroidism and Addison’s disease due to autoantibodies against both the thyroid and the adrenals
Hyponatraemia + hyperkalaemia (mineralocorticoid deficiency)
Hypoglycaemia (glucocorticoid (cortisol) deficiency)
low T4 high TSH (Primary hypoparathyroidism)
Which test is used to diagnose Addison’s disease ?
Short synACTHen test
Explain how the short synACTHen test works and what results you would expect in Addison’s disease ?
1)- measure initial cortisol +ACTH
2)- Administer synthetic ACTH by IM injection
3)- check cortisol at 30 and 60 mins
In normal people cortisol should be able get to >550 nM
In Addison’s disease Cortisol does increase after synthetic ACTH and stays <10nM
Which test is used to diagnose phaeochromocytoma ?
Urine catecholamines - high = phaeochromocytoma
What is a phaeochromocytoma ?
An adrenal medullary tumour that secretes adrenaline causing hypertension, arrhythmias, sweating, impending sense of doom
List 3 genetic conditions in which phaeochromocytoma is seen ?
MEN2
Von Hippel Lindau syndrome
Neurofibromatosis type 1
List 3 features of MEN2a?
Parathyroid tumours
Medullary thyroid cancer
Phaeochromocytoma