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ENR Biweekly 3 > Sos- Adrenal Disorders > Flashcards

Sos- Adrenal Disorders Flashcards

1
Q

____ glands are crucial for homeostasis

A

endocrine

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2
Q

what to be mindful of when removing R kidney

A

IVC (due to short suprarenal vein)

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3
Q

how adrenal medulla is connected to nervous system

A

innervated by sympathetics and chromaffin cells are stimulated by Ach that is released

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4
Q

location of adrenal glands

A

T12-L1 (retroperitoneal too)

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5
Q

zona glomerulosa regulated by

A

Ang II (RAAS)

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6
Q

zona fasciculata and reticularis regulated by what

A

CRH and ACTH

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7
Q

chromaffin cells of medulla are regulated by what

A

preganglionic sympathetic fibers

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8
Q

normally, ____ acts to block inflammation and maintain homeostasis in the body

A

cortisol

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9
Q

Autonomic NS is fast and overrides _____ in moments of fight or flight

A

endocrine

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10
Q

someone with HTN, obesity, advanced diabetes

A

overriding endocrine system to the point where it’s not functioning anymore

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11
Q

21-hydroxylase deficiency is the most common cause

A

congenital adrenal hyperplasia (bilateral)

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12
Q

Most common cause of ambiguous genitalia in female newborns

A

congenital adrenal hyperplasia

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13
Q

75% have salt wasting
Weight loss and dehydration
Adrenal crisis
Elevated 17oh progesterone 48 hrs
Skin pigmentation due to melanocyte stimulating hormone

A

congenital adrenal hyperplasia

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14
Q

what happens in congenital adrenal hyperplasia when the cause is 21-hydroxylase deficiency

A

decreased cortisol and aldosterone and increased androgens

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15
Q

Most common
Infants have salt wasting
Precocious puberty
XX virilization

A

21-hydroxylase deficiency

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16
Q
A

21-hydroxylase deficiency

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17
Q

why does K+ increase with 21-hydroxylase deficiency

A

b/c aldosterone (and cortisol) are decreased, so that will increase K+ in the serum

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18
Q

primary hypothalamic/pituitary disease associated with hypersecretion of ACTH

A

Cushing Disease

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19
Q

____disease results in ____ syndrome and also there can be many causes for the syndrome

A

Cushing

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20
Q

most common exogenous cause of Cushing Syndrome

A

(medications)/iatrogenic

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21
Q

most common endogenous cause of Cushing syndrome

A

pituitary adenoma (ACTH)

22
Q

ACTH dependent endogenous cause of Cushing syndrome that is not pituitary adenoma

A

paraneoplastic

23
Q

main cause of cushing syndrome that is ACTH independent

A

adrenal cortex adenoma

24
Q

Presents with muscle weakness (cortisol metabolizes muscle), HTN, osteoporosis, immune suppression, moon facies truncal obesity and back fat accumulation

A

Cortisol Syndrome

25
Q
A

exogenous corticosteroids causing Cushing syndrome

26
Q
A

primary adrenal adenoma causing cushing syndrome

27
Q
A

ACTH secreting pituitary adenoma causing Cushing syndrome

28
Q
A

Paraneoplastic ACTH secretion causing Cushing syndrome

29
Q

most common form of Cushing syndrome

A

Iatrogenic Cushing Syndrome

30
Q

used to treat autoimmune and inflammatory diseases and causes iatrogenic cushing syndrome

A

glucocorticoids

31
Q
A

Pituitary ACTH adenoma causing Cushing’s Syndrome

32
Q

Secretion of ectopic ACTH by non-pituitary tumors accounts for 10% of cases of Cushing Syndrome

A

ectopic paraneoplastic cushing syndrome

33
Q

Associated neoplasms:
Small cell carcinoma of the lung
Neuroendocrine tumors
Medullary carcinoma of the thyroid

A

paraneoplastic cushing syndrome

34
Q
A

adrenal cushing syndrome caused by cortical adenoma

35
Q

well circumscribed, cortical, yellow in color

A

Adrenal adenoma

36
Q

decreased production of cortisol and aldosterone; rare

Develops slowly and when the patient has a stress (illness or trauma), symptoms worsen

A

Addison’s disease

37
Q

adrenal insufficiency that worsens due to stress (illness or trauma)

A

Addison’s disease

38
Q

Symptoms:
Hypoglycemia, hypotension, fatigue
Abdominal pain, nausea, diarrhea and vomiting
Salt craving
Muscle and joint pain
Weight loss

Can progress to a crisis state

A

Addison’s Disease

39
Q

Young (30-50)
Not diagnosed at birth

Stress to body, and then it appears

Adrenal glands fail and the individuals cant cope with it and cant make cortisol or aldosterone (electrolytes out of whack)

A

Adrenal Crisis

40
Q

Clinical presentation:
Unexplained hypoglycemia and fever
Dehydration, hypotension or shock out of proportion to current illness
Abdominal pain, nausea and vomiting with a history of weight loss
Hyponatremia, hyperkalemia, hypercalcemia

A

Adrenal Crisis

41
Q

way too much aldosterone
treatment resistant HTN
affects kidneys, heart, blood vessels

A

Conn’s disease (primary aldosteronism)

42
Q

2 adrenal medullary tumors

A

neuroblastoma
pheochromocytoma

43
Q

Racoon eyes (cancer metastasized to behind the eyes) + mass in abdomen

A

neuroblastoma of adrenal medulla

44
Q

Catch before 2 years—–80% survival
neural crest derived
increased levels of urinary catecholamines

A

Neuroblastoma

45
Q

Homer-Wright rosettes
IHC + for NSE, synaptophysin, chromogranin

A

Neuroblastoma

46
Q

arises from adrenal medulla or sympathetic chain ganglia

A

Neuroblastoma

47
Q

Zellballen pattern (nests or balls of cells surrounded by connective tissue)

A

Pheochromocytoma

48
Q

Rule of 10’s
10% malignant, bilateral, extra-adrenal, calcify, in kids

A

pheochromocytoma

49
Q

IHC+ for NSE, synaptophysin, and chromogranin
Most common tumor in adults, but rare

A

pheochromocytoma

50
Q

HTN that doesn’t respond to HTN meds
Mahogany brown (cortex still functioning) but medulla growing

A

pheochromocytoma

51
Q

produces large amount of epinephrine

A

pheochromocytoma

52
Q

Episodic hyperadrenergic symptoms, the 5 P’s:
Pressure, increased BP
Palpitations, heart tachycardia
Pain, headaches
Perspiration
Pallor

A

Pheochromocytoma

ENR Biweekly 3 (14 decks)

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