Diagnosis of Adrenal Disease

Question 1

What is a pheochromocytoma?

Answer 1

tumour secreting too much catecholamines

Question 2

Adrenal Cortex Mnemonic?

Answer 2

Go Find Rex
Make Good Sex

Glomerulosa: Mineralocorticoids
Fasciculata: Glucocorticoids
Reticularis: Sex Hormones

Question 3

Cortisol =

Answer 3

Hydrocortisone

Question 4

What is cortisone?

Answer 4

inactive metabolite

Question 5

What is 11-deoxycorticosterone?

Answer 5

precursor to aldosterone

Question 6

what is parent molecule for steroids?

Answer 6

cholesterol

Question 7

Hydrocortisone =

Answer 7

Cortisol

Question 8

What does Glucocorticoids do in the:
Liver
Muscle
Adipose Tissue
Immune System

Answer 8

Liver: gluconeogensis
Muscle: mobilisation of AAs
Adipose Tissue: lipolysis
Immune suppression

Question 9

too much cortisol and growth?

Answer 9

inhibition of linear growth

Question 10

ACTH-dependent hypercortisolism cause and name?

Answer 10

pituitary adenoma (Cushing’s Disease)

Question 11

ACTH-independent hypercortisolism cause and name?

Answer 11

Adrenal tumour (Cushing’s Syndrome)

Question 12

What’s another way to get ACTH-independent hypercortisolism that’s not tumour of nodular?

Answer 12

excess administration of glucocorticoids

Question 13

Cushing’s get hyper or hypotension?

Answer 13

hypertension

Question 14

Name signs and symptoms of Cushing’s syndrome?

Answer 14

Moon Face
Obesity
Hirsutism
Menstrual Disorders
Bruising
Striate
Buffalo Hump
Fat deposit in trunk and face
weakness
acne
osteoporosis

Question 15

When do you measure random hormones for Cushing’s testing?

Answer 15

Never. Measure specific tropic and hormone

Question 16

When use radiology in endocrine testing?

Answer 16

Biochemical testing first

Question 17

Name the Trophic factor for:
T4
Corticol
Oestrogen
Testosterone

Answer 17

T4: TSH
Corticol: ACTH
Oestrogen: FSH/LH
Testosterone: LH

Question 18

4 dx ways to test for Cushing’s

Answer 18

1. 24h urine
2. diurnal variation
3. dexamethasone supp’n test
4. MRI/CT

Question 19

blood pressure in low cortisol?

Answer 19

Low

Question 20

Skin in low cortisol?

Answer 20

darkening b/c more ACTH - increase melanin

Question 21

2 Infectious causes of adrenocortical insufficiency?

Answer 21

TB

fungal

Question 22

Most common cause of Addison’s disease in Australia?

Answer 22

Autoimmune disease

Question 23

What is fludrocortisone?

Answer 23

aldosterone analogue

Question 24

How to treat Addison’s disease?

Answer 24

Cortisol/Fludrocortisone replacement

Question 25

Vitiligo:

Answer 25

Autoimmune against melanocytes in Addison's

Question 26

Excess adrenal androgen in child affect growth how?

Answer 26

rapid epiphyseal fusion

Question 27

90% of cases of congenital adrenal hyperplasia caused by what?

Answer 27

enzyme: 21 hydroxylase deficiency: no cortisol/aldosterone>no feedback> increase androgens

Question 28

what are 3 presentations of congenital adrenal hyperplasia in females?

Answer 28

1. ambiguous genitalia 2. premature pubic hair/enlarged clitoris 3. adolescent hirsutism

Question 29

2 presentations of congenital adrenal hyperplasia in males:

Answer 29

1. adrenal crisis: not enough salt/water retention because no Aldosterone 2. premature sexual development at age 2-3

Question 30

What 2 things regulates aldosterone secretion?

Answer 30

1. increase in K+/decrease in Na+ and H20 | 2. angiotensin II

Question 31

2 signs of excess aldosterone?

Answer 31

1. hypertension (hypernatraemia) | 2. weakness (hypokalemia)

Question 32

2 signs of deficient aldosterone?

Answer 32

1. dehydration, Na+ depletion | 2. Cardiac arrythmias (hyperkalemia)

Question 33

What is Conn's Syndrome?

Answer 33

adrenocortical tumour secreting aldosterone

Question 34

Symptoms of Conn's Syndrome?

Answer 34

Hypertension | Weakness due to hypokalaemia

Question 35

Cure for Conn's syndrome?

Answer 35

Surgery

Question 36

Do you need catecholamines to survive?

Answer 36

Not really