Small Groups: Adrenal Disorders

Question 1

One of the features that makes it difficult to confirm diagnosis of pheochromocytoma is ______________.

Answer 1

that the tumor only secretes catecholamines episodically, so there might not be excess catecholamines the moment you check for them

Question 2

High levels of what molecule suggest malignant pheochromocytoma?

Answer 2

Dopamine

Question 3

A very high DHEA level suggests _______________.

Answer 3

an adrenal tumor that primarily secretes androgens

Question 4

Why should you initially give dexamethasone to someone with suspected adrenal insufficiency?

Answer 4

Because dexamethasone does not show up as cortisol in cortrosyn stimulation tests, you would still be able to differentiate the cause of the patient’s adrenal insufficiency.

Question 5

__________ withdrawal can mimic the symptoms of pheochromocytoma.

Answer 5

Alcohol

Question 6

Conn’s syndrome accounts for about ________ percent of cases of hypertension.

Answer 6

5% - 10%

Question 7

Explain the pathophysiology of glucocorticoid-remediable hyperaldosteronism.

Answer 7

An autosomal dominant disorder in which aldosterone synthase gets fused with the ACTH-induced 11-beta-hydroxylase. Giving glucocorticoids decreases the release of ACTH and thus down-regulates the aberrant enzyme.

Question 8

Addison’s disease is characterized by these symptoms: ___________________.

Answer 8

weakness, fatigue, nausea, anorexia, dizziness, and abdominal pain

Question 9

What symptoms suggest adrenal crisis?

Answer 9

Hypotension, fever, and confusion (administer 100 mg hydrocortisone)

Question 10

________________ typically present with the highest ACTH values.

Answer 10

Ectopic ACTH-secreting tumors