Excess of Adrenal Hormones Flashcards
What is the classic triad of symptoms which presents with pheochromocytoma?
- High HR/BP
- Sweats
- Headaches
50% postural hypotension
What is a phaeochromocytoma?
Tumour of the chromaffin cells (majority occur in the adrenal medulla)
What does a phaeochromocytoma cause an increase in?
Noradrenaline and adrenaline
How is phaeochromocytoma diagnosed?
- Urine measurement of catecholamine (noradrenaline + adrenaline) excess
- Establish site of excess
- MRI
- MIBG scan
How is phaeochromocytoma managed?
- Alpha blockers - PHenoxybenzamine
- Beta blockers - propanolol
- Adrenalectomy
PHaeochromoyctoma = PHenoxybenzamine
What is the most common cause of primary aldosteronism?
Bilateral adrenal hyperplasia
What is Conn’s syndrome?
Can be used as a way of describing primary aldosteronism
But specifically is an adrenal adenoma secreting aldosterone
What is the main symptom of primary aldosteronism?
HTN (which presents in patient with no risk factors/can’t be managed through normal drug treatment)
What are the two steps to diagnosing primary aldosteronism?
- High aldosterone, low renin
2. Saline suppression test
How is primary aldosteronism managed?
Unilateral = curative surgery Bilateral = MR antagonist = spirolactone
Name common presentations of Cushing’s syndrome?
- Central obesity
- Thin arms and legs
- Easy bruising (due to increased fat and muscle breakdown)
- Fat pad at back of neck
- “Moon face”
- Striae on stomach
- HTN
Explain the difference between Cushing’s disease and Cushing’s syndrome?
Cushing’s syndrome = excess cortisol
Cushing’s disease = pituitary adenoma causing increase in ACTH -> increase in cortisol
What symptoms can help differentiate Cushing’s syndrome from obesity?
- Thin skin
- Proximal myopathy
What drug can cause Cushing’s syndrome?
Steroids - cause increase in cortisol
How is Cushing’s disease diagnosed?
Overnight dexomethasone test
