clinical adrenal

Question 1

2 general presentations of adrenal disorders

Answer 1

1. hormonal

2. mass effect

Question 2

3 hormonal presentations of adrenal

Answer 2

1. overproduction
2. underproduction
3. mixed

Question 3

4 possible overproduction syndromes

Answer 3

1. GC - cushings
2. MC - Conn’s
3. Sex - virilization
4. epi - pheochromocytoma

Question 4

disorder of underproduction

Answer 4

addison’s

Question 5

disorder of mixed production

Answer 5

CAH

Question 6

3 types of mass effects

Answer 6

1. single
2. multiple
3. hyperplasia

Question 7

Sx of cushings

Answer 7

1. central obesity
2. moon face
3. metabolic syndrome
4. weakness
5. osteoporosis
6. stria (purple)

Question 8

what is lab test for cushings

Answer 8

24hr cortisol test

Question 9

what is used for cushings suppression test

Answer 9

dexamethosone

Question 10

what to look for in supression test

Answer 10

1. ACTH high - secondary (pit) or ectopic

2. ACTH low - adrenal (primary)

Question 11

what are 2 main Sx of hyperaldosteronsim and why?

Answer 11

hypertension -Na

hypokalemia - K excretion

Question 12

what hormones expected to see in hyperaldosteronism (2)

Answer 12

1. high aldosterone

2. low renin

Question 13

what is suppression test for aldosteron

Answer 13

salt load -

Question 14

what hormone to look at to determine where problem is?

Answer 14

renin - high = secondary

renin - low = primary

Question 15

what is most effective drug in primary hyperaldosteronism

Answer 15

Na channel blocker - works at level of kidney - post aldo

Question 16

other medical treatment of hyperaldosterone

Answer 16

aldostreone receptor blocker

Question 17

what is suspect in cases of severe sexual virilization

Answer 17

adrenal carcinoma

Question 18

what to measure in severe virilization

Answer 18

DHEAS - adrenal specific

Question 19

what is pheochromocytoma

Answer 19

high catecholames

Question 20

what are Sx of pheo

Answer 20

3 Ps:pain(head), palpitations, perspiration + hypertension

Question 21

what to measure to confirm pheo

Answer 21

epiner/norepi + metanephrine/noemeta

Question 22

what is preoperative treatment of pheo

Answer 22

a-blocker to help with vasoconsriction, if tachycardic - add B-blocker

Question 23

what is adrenal underproduction

Answer 23

addisons

Question 24

what are Sx of addisons

Answer 24

low BP that DROPs on standing
low Na
low glucose
high K
hyperpigmentation

Question 25

what is first thing to do in hyperadrenal

Answer 25

TREAT via saline and high dose steroids

Question 26

what is test to assess level

Answer 26

ACTH