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RWJ Endo Repro > Lubitz Adrenal Endocrinology > Flashcards

Lubitz Adrenal Endocrinology Flashcards

1
Q

Synthetic cortisol adequately detect adrenal deficiency, but why can’t it distinguish between primary and central? (Give Two answers)

A
  • Primary means nonresponsive kidney

- Secondary results in a shriveled adrenal gland.

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2
Q

Zona Glomerulosa makes _____ hormones

A

Mineralocorticoid

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3
Q

Parathyroid hyperplasia*, medullary thyroid carcinoma, and Pheochromocytoma are all associated with MEN___

A

2A

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4
Q

With respect to secondary adrenal insufficiency, how does it differ from primary?

A

Intact RAAS for Secondary!

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5
Q

In the face of hypercortisolism with LOW plasma ACTH, where is the disorder localized?

A

The Adrenal [ACTH-Independent]

adenoma, carcinoma, or hyperplasia

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6
Q

What syndrome is associated with Hyper-Aldosteronism?

A

Conn’s Syndrome

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7
Q

Excess cortisol can overwhelm the enzyme ______ resulting in more Mineralocorticoid (ALD).

A

11-Beta-HSD2

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8
Q

Cushing’s overwhelms the 11B-HSD2 enzyme and ends up making a lot of ______

A

Mineralocorticoids

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9
Q

The adrenal cortex arises from _____ of the embryo

A

Mesoderm

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10
Q

Zona reticularis makes ____ hormones products

A

Androgen

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11
Q

When testing for Cushing’s CRH will NOT cause ACTH or cortisol to boost if the disease is located in the ______

A

Ectopic Area

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12
Q

Pheochromocytomas are associated with MEN___ and ___ syndromes

A

2A, 2B

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13
Q

Adrenal meduula makes ____ hormones

A

Catecholamine

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14
Q

Pituitary Adenoma, Parathyroid Hyperplasia*, and Pancreatic Tumors are associated with MEN___

A

1

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15
Q

3 MEN 1 Syndromes?

“The first man really had to pee”

A
  1. Parathyroid Hyperplasia
  2. Pancreatic Tumor
  3. Pituitary Adenoma
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16
Q

Cushing’s Disease means the disorder is localized to the ______

A

Pituitary Gland

17
Q

Most common cause of Primary Adrenal Insufficiency?

A

Auto-Immune

18
Q

The adrenal medulla arises from ____ ___ of the embryo

A

Neural Crest

19
Q

Aside from a 24 hr urinary test or late-night salivary cortisol test, how do you screen for Cushing’s Syndrome?

A

Overnight Dexamethasone

to test for hyper-secretion, inhibit

20
Q

Easiest way to determine if there is a primary adrenal deficiency via a Physical Exam?

A

Hyperpigmentation

High ACTH levels linked to a-MSH

21
Q

3 MEN 2A Syndromes?

“The Second man is wild “

A
  1. Parathyroid hyperplasia
  2. Medullary thyroid carcinoma
  3. Pheochromocytoma
22
Q

How to treat psuedo-cushing’s?

A

Tx Underlying disease!

23
Q

Look for the lab finding of hyper_____ if adrenal insufficiency is primary.

A

Kalemia

because all layers of kidney get hit

24
Q

If a patient is not responding to catecholamines, then you should be clued in for _____ insufficency

A

Adrenal

25
Q

Zona Fasciculata makes ____ hormones

A

Glucocorticoids

26
Q

Mucosal neuromas and Marfanoid body, Medullary thyroid carcinoma and pheochromocytomas are associated with MEN____ disorders

A

2B

27
Q

Hypercortisolism from Pituitary or Ectopic can be distinguished by a _____ Stimulation Test

A

CRH

(Tumor won’t respond), PIT will produce more ACTH and Cort

28
Q

The most common tumor diagnosed <1 year of age is _______ associated with N-myc oncogene

A

Neuroblastoma

29
Q

What are the 2 ACTH-Dependent syndromes?

A
  1. Cushing’s Disease (Pit)

2. Ectopic (Small Cell Lung Cancer)

30
Q

In the face of hypercortisolism with HIGH plasma ACTH, where is the disorder localized?

A

Either Pituitary OR Ectopically (ACTH-Dependent)

31
Q

What is the size of an Adrenocortical Carcinoma?

A

Large usually >4cm

32
Q

What is Adrenal Waterhouse-Friderichsen Syndrome? (extra credit: what pathogen causes it commonly?)

A

Hemorrhaging of adrenal glands

usually Neisseria Meningitidis

33
Q

Pseudo-Cushing’s is linked with ______ that result in excess release of CRH and the normal negative feedback doesn’t work. Doesn’t present as severe.

A

Stressors

over-exercise, eating disorders, pain, alcoholism, obesity, etc.

34
Q

When testing for Cushing’s CRH will cause ACTH and Cortisol to boost if the disease is located in the ______

A

Pituitary

35
Q

Parathyroid hyperplasia appears in both MEN____ and ____ disorders

A
  • 1

- 2A

36
Q

Mucosoal neuromas and Marfanoid body identifies MEN2____ as opposed to the similar MEN 2____ which doesn’t have that.

A

2A, 2B

RWJ Endo Repro (26 decks)

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