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Y3R5: Medicine I 🩺 > L11: Adrenal Gland Disorders > Flashcards

L11: Adrenal Gland Disorders Flashcards

1
Q

Revise Introduction from notes

A

First 2 Pages

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2
Q

Def of Cushing Syndrome

A
  • A diverse symptom complex resulting from excess steroid hormone production by the adrenal cortex (endogenous) or to sustained administration of
    glucocorticoids (exogenous)
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3
Q

what is Cushing Disease?

A

refers to → over secretion of ACTH from a pituitary adenoma

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4
Q

Causes of Cushing Syndrome

A
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5
Q

Causes of ACTH independent Cushing

A
  • Overproduction of glucocorticoids may be due to an adrenal adenoma, adrenal carcinoma, or adrenal hyperplasia
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6
Q

what is the most common cause of Cushing Syndrome?

A

Exogenous glucocorticoid intake (Iatrogenic Cushing)

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7
Q

ACTH dependent Cushing by pituitary adenoma

A

Pituitary adenomas that secrete ACTH are derived from corticotroph cells in the anterior pituitary.

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8
Q

Obesity

  • Cushing Syndrome
A

 Generalized obesity in addition to centripetal (truncal) obesity

 Moon facies

 Buffalo hump

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8
Q

Cushing syndrome due to Ectopic Secretion

A
  • Ectopic ACTH secretion is caused by small-cell lung tumors, carcinoid tumors
  • Ectopic CRH secretion leading to increased ACTH secretion comprises a very rare group of cases of Cushing syndrome.
  • Ectopic cortisol secretion from a case of ovarian carcinoma.
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9
Q

CP of Cushing Syndrome

A
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10
Q

Reproductive dysfunction

  • Cushing Syndrome
A

 Gonadal dysfunction with menstrual irregularity in females and loss of libido in both sexes

 Hirsutism

 Acne

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11
Q

Psychiatric abnormalities

  • Cushing Syndrome
A
  • Agitated depression
  • Overt Psychosis
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12
Q

Bone

  • Cushing Syndrome
A

Generalized osteoporos

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13
Q

Skin

  • Cushing Syndrome
A
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14
Q

what causes increased skin pigmentation in Cushing Syndrome?

A

Increased skin pigmentation d2 overstimulation of melanocyte receptors by ACTH (only in ACTH dependent Cushing)

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15
Q

Muscle

  • Cushing Syndrome
A

Myopathy

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16
Q

CVS

  • Cushing Syndrome
A
  • Hypertension
  • Together with other metabolic derangement, as diabetes, may lead to increased mortality
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17
Q

Infection

  • Cushing Syndrome
A

 Fungal infections
 Reactivation of TB
 Wound infection and impaired healing

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18
Q

Investigations for Cushing Syndrome

A

Lab:
- Confirmation of hypercortisolism
- Differentiation of Cushing Syndrome
- In addition to others

Rad:
- Pituitary MRI with contrast
- Abdominal (Suprarenal) CT
- Chest X-Ray or CT

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18
Q

Eye

  • Cushing Syndrome
A

 Cataract
 Raised intra ocular pressure
 Exophthalmos because of increased retro orbital fat

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19
Q

Metabolic & Endocrine

  • Cushing Syndrome
A

 Impaired glucose tolerance or Diabetes Mellitus
 Hypokalemic alkalosis
 Hypogonadotropic Hypogonadism (reversible)
 Water retention

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20
Q

Confirmation of hypercortisolism

  • Cushing Syndrome
A
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21
Q

Rad Dx of Cushing Syndrome

A

 Pituitary MRI with contrast : For pituitary adenoma
 Abdominal (Suprarenal) CT : For adrenal causes
 Chest X-Ray or CT : For ectopic Cushing

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22
Q

Diffrentiation of Cushing Syndrome

  • Cushing Syndrome
A
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23
Q

IPSS

  • Cushing Syndrome
A
24
Q

TTT of Cushing Syndrome

A
25
Q

Medical TTT of Cushing Syndrome

A
25
Q

Surgical TTT of Cushing Syndrome

A
26
Q

Irradiation therapy of Cushing Syndrome

A
  • Irradiation of the pituitary could be reverted to when Trans-sphenoidal surgery is not successful or not possible.
  • Late-onset adverse effects include hypopituitarism
27
Q

Post-Operative Managment of Cushing Syndrome

A

Clearly, if both adrenals are removed, replacement with prednisolone is a lifelong treatmen

28
Q

Nelson’s Syndrome

A
29
Q

Causes of Pseudo-Cushing Syndrome

A
30
Q

Def of Pseudo-Cushing Syndrome

A

Group of reversible disorders with subtle symptoms and signs of Cushing’s syndrome and hypercortisolism with defective response to dexamethasone suppression tests.

31
Q

Def of Cyclical Cushing Syndrome

A
32
Q

These patients require frequent monitoring with urine free cortisol or late-night salivary cortisol to establish the diagnosis, as cycle length varies from days to months.

  • Cyclical Cushing Syndrome
A

..

33
Q

Inadequate cortisol in times of stress can lead to ……….

A

hypotension, shock, and hypoglycemia

34
Q

……… deficiency typically leads to renal wasting of sodium, retention of potassium, and reduced intravascular volume.

A

Mineralocorticoid

35
Q

Types of Suprarenal Failure (Adrenal Insufficiency)

A
36
Q

what is addison’s disease?

A
  • Is an uncommon disorder that occurs when body doesn’t produce enough of certain hormones.
  • In Addison’s disease, adrenal glands produce too little cortisol and too little aldosterone
37
Q

Def of Addison’s disease

A
  • Is an uncommon disorder that occurs when body doesn’t produce enough of certain hormones.
  • In Addison’s disease, adrenal glands produce too little cortisol and too little aldosterone
38
Q

Causes of Addison’s disease

A
39
Q

What is the most common cause of Addison’s disease in developed countries?

A

Autoimmune disease is the most common cause in developed countries
(90%)

40
Q

Symsptoms of Addison’s disease

A
41
Q

What is the most common cause of Addison’s disease in developing countries?

A

Tuberculosis (<10%) most common cause in developing countries

42
Q

DDx of hyperpigmentation

A
43
Q

Dx of Addison’s disease

A
44
Q

Blood tests in Dx of Addison’s disease

A
45
Q

ACTH stimulation test in Addison’s disease

A
45
Q

Hx in Dx of Addison’s disease

A

Dark patches on skin might be a clue to consider testing for Addison’s disease

46
Q

X-Rays in Dx of Addison’s disease

A

Calcium deposits on the adrenal glands

47
Q

TTT of Addison’s disease

A
48
Q

CT in Dx of Addison’s disease

A

Adrenals and/or pituitary gland.

49
Q

Difference between 1ry & 2ry Adrenal insufficiency

A
49
Q

Causes of Secondary Adrenal Insufficiency

A
50
Q

Causes of Acute Hypoadrenalism (Addisonian Crisis)

A
51
Q

CP of Acute Hypoadrenalism (Addisonian Crisis)

A
52
Q

INVx for Acute Hypoadrenalism (Addisonian Crisis)

A

 Plasma cortisol < 5 mcgm
 Hypoglycemia
 Hyponatremia
 Hyperkalemia

53
Q

DDx of Acute Hypoadrenalism (Addisonian Crisis)

A

 Hypotension resistant to vasopressor agents
 Medical cause of acute abdomen
 PUO ( pyrexia of unknown origin )
 D.D of underlying etiology

54
Q

Read Power Questions from notes

A

pages 18 & 19

55
Q

TTT of Acute Hypoadrenalism (Addisonian Crisis)

A
56
Q

..

A

..

Y3R5: Medicine I 🩺 (47 decks)

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