The Endocrine Syndrome: adrenal - Graffeo

Question 1

What are 3 layers of the cortex and what do they secrete

Answer 1

Zona glomerulosa: cortisol and Al
Zona fasciculata: cortisol and andorgen
Zona reticularis: estrogens and androgens

Question 2

what does the medulla secrete

Answer 2

catecholamines

Question 3

What is the exogenous cause of hypercortisolism ( cushing)

Answer 3

Iatrogenic: caused by giving exogenous glucorticoids

Question 4

What are endogenous causes of Cushings

Answer 4

1. primary hypothalamic-pituitary (increase ACTH)
2. primary adrenocortical neoplasm
3. secretion of ectopic ACTH

Question 5

what is a most likely cause of ectopic ACTH by neuroendocrine tumors

Answer 5

small cell carcinoma of lung

Question 6

what are early symptoms of cushings

Answer 6

hypertension

weight gain

Question 7

what are late symptoms of cushings

Answer 7

truncal obesity
“moon” faces
“buffalo Hump”

Question 8

How does cushings impact other organ systems

Answer 8

atrophy of fast twitch muscles (II)

Question 9

Other symptoms of cushings

Answer 9

hyperglycemia
striae
poor wound healing
posterior neck adiposity

Question 10

if cushings is caused by steroids then what happens to ACTH and adrenals.

Answer 10

decreased ACTH

atrophy of adrenal

Question 11

due to endogenous causes in cushings what happens to the adrenal cortex

Answer 11

hyperplasia

Question 12

Either pituitary ACTH or ectopic stimulates the adrenal and results in what

Answer 12

• bilateral nodular adrenocortical hyperplasia

Question 13

gross difference between adrenal adenoma and carcioma

Answer 13

adenoma: encapsulated, yellow tumors
carinoma: larger

Question 14

which adrenocortical neoplasm usually has non functional or functional adrenal gland

Answer 14

adenoma: nonfunctional
carcinoma: functional

Question 15

what causes crooke’s hyaline

Answer 15

high levels of cortisol

Question 16

what does the Dexamethasone test show for pituitary cushings

Answer 16

• low dose ACTH not suppressed

- high dose ACTH suppressed

Question 17

what does the Dexamethasone test show for ectopic - ACTH cushing

Answer 17

neither high or low dose of Dexa suppresses

Question 18

what does the Dexamethasone test show for adrenal cushing

Answer 18

• neither low or high dose suppresses

Question 19

Primary hyperaldosteronism impacts what hormone

Answer 19

decreases renin

Question 20

Secondary hyperaldosteronism impacts what hormone

Answer 20

increases renin

Question 21

Presence of solitary aldosterone secreting adenoma is called what syndrome

Answer 21

Conn syndrome

Question 22

what are sodium and potassium levels for hyperaldosteronism

Answer 22

sodium retention

potassium excretion

Question 23

what gender gets hyperaldosteronism more frequently

Answer 23

females

Question 24

what causes primary hyperaldosteronism

Answer 24

adenomas and/or hyperplasia

Question 25

what happens in clugocorticoid-supressible cause of hyperaldosteronism

Answer 25

derangement in zonation | - hybrid cells ( zona glomerulosa and zona fasiculata)

Question 26

how do you treat adenoma hyperaldosteronism

Answer 26

surgical correction of hypertension

Question 27

name two adrenogential syndromes

Answer 27

adrenocortical neoplasms | congenital adrenal hyperplasia

Question 28

how is congenital adrenal hyperplasia inherited

Answer 28

autosomal recessive

Question 29

what is the defect in congenital adrenal hyperplasia

Answer 29

21-hydroxylase deficiency - decrease cortisol causes - increase ACTH ( adrenocortical hyerplasia)

Question 30

what are hormonal impacts from congenital adrenal hyperplasia

Answer 30

- decrease cortisol causes - increase ACTH ( adrenocortical hyerplasia) - increased androgen activity - 1/3 Na wasting

Question 31

what cultural groups get congenital adrenal hyperplasia

Answer 31

hispanics | Ashkenazi jews

Question 32

increased ACTH in congenital adrenal hyperplasia causes what

Answer 32

bilateral nodular adrenal hyperplasia

Question 33

how is congenital adrenal hyperplasia treated? what are the risks

Answer 33

exogenous glucocorticoids - suppress ACTH - risk of acute adrenal insufficiency

Question 34

what composes the adrenal myelolipoma

Answer 34

fat and hematopoietic cells