Diagnosis of Adrenal Disease Flashcards
What is a pheochromocytoma?
tumour secreting too much catecholamines
Adrenal Cortex Mnemonic?
Go Find Rex
Make Good Sex
Glomerulosa: Mineralocorticoids
Fasciculata: Glucocorticoids
Reticularis: Sex Hormones
Cortisol =
Hydrocortisone
What is cortisone?
inactive metabolite
What is 11-deoxycorticosterone?
precursor to aldosterone
what is parent molecule for steroids?
cholesterol
Hydrocortisone =
Cortisol
What does Glucocorticoids do in the: Liver Muscle Adipose Tissue Immune System
Liver: gluconeogensis
Muscle: mobilisation of AAs
Adipose Tissue: lipolysis
Immune suppression
too much cortisol and growth?
inhibition of linear growth
ACTH-dependent hypercortisolism cause and name?
pituitary adenoma (Cushing’s Disease)
ACTH-independent hypercortisolism cause and name?
Adrenal tumour (Cushing’s Syndrome)
What’s another way to get ACTH-independent hypercortisolism that’s not tumour of nodular?
excess administration of glucocorticoids
Cushing’s get hyper or hypotension?
hypertension
Name signs and symptoms of Cushing’s syndrome?
Moon Face Obesity Hirsutism Menstrual Disorders Bruising Striate Buffalo Hump Fat deposit in trunk and face weakness acne osteoporosis
When do you measure random hormones for Cushing’s testing?
Never. Measure specific tropic and hormone
When use radiology in endocrine testing?
Biochemical testing first
Name the Trophic factor for: T4 Corticol Oestrogen Testosterone
T4: TSH
Corticol: ACTH
Oestrogen: FSH/LH
Testosterone: LH
4 dx ways to test for Cushing’s
- 24h urine
- diurnal variation
- dexamethasone supp’n test
- MRI/CT
blood pressure in low cortisol?
Low
Skin in low cortisol?
darkening b/c more ACTH - increase melanin
2 Infectious causes of adrenocortical insufficiency?
TB
fungal
Most common cause of Addison’s disease in Australia?
Autoimmune disease
What is fludrocortisone?
aldosterone analogue
How to treat Addison’s disease?
Cortisol/Fludrocortisone replacement
Vitiligo:
Autoimmune against melanocytes in Addison’s
Excess adrenal androgen in child affect growth how?
rapid epiphyseal fusion
90% of cases of congenital adrenal hyperplasia caused by what?
enzyme: 21 hydroxylase deficiency: no cortisol/aldosterone>no feedback> increase androgens
what are 3 presentations of congenital adrenal hyperplasia in females?
- ambiguous genitalia
- premature pubic hair/enlarged clitoris
- adolescent hirsutism
2 presentations of congenital adrenal hyperplasia in males:
- adrenal crisis: not enough salt/water retention because no Aldosterone
- premature sexual development at age 2-3
What 2 things regulates aldosterone secretion?
- increase in K+/decrease in Na+ and H20
2. angiotensin II
2 signs of excess aldosterone?
- hypertension (hypernatraemia)
2. weakness (hypokalemia)
2 signs of deficient aldosterone?
- dehydration, Na+ depletion
2. Cardiac arrythmias (hyperkalemia)
What is Conn’s Syndrome?
adrenocortical tumour secreting aldosterone
Symptoms of Conn’s Syndrome?
Hypertension
Weakness due to hypokalaemia
Cure for Conn’s syndrome?
Surgery
Do you need catecholamines to survive?
Not really
