The Endocrine Syndrome: adrenal - Graffeo Flashcards
What are 3 layers of the cortex and what do they secrete
Zona glomerulosa: cortisol and Al
Zona fasciculata: cortisol and andorgen
Zona reticularis: estrogens and androgens
what does the medulla secrete
catecholamines
What is the exogenous cause of hypercortisolism ( cushing)
Iatrogenic: caused by giving exogenous glucorticoids
What are endogenous causes of Cushings
- primary hypothalamic-pituitary (increase ACTH)
- primary adrenocortical neoplasm
- secretion of ectopic ACTH
what is a most likely cause of ectopic ACTH by neuroendocrine tumors
small cell carcinoma of lung
what are early symptoms of cushings
hypertension
weight gain
what are late symptoms of cushings
truncal obesity
“moon” faces
“buffalo Hump”
How does cushings impact other organ systems
atrophy of fast twitch muscles (II)
Other symptoms of cushings
hyperglycemia
striae
poor wound healing
posterior neck adiposity
if cushings is caused by steroids then what happens to ACTH and adrenals.
decreased ACTH
atrophy of adrenal
due to endogenous causes in cushings what happens to the adrenal cortex
hyperplasia
Either pituitary ACTH or ectopic stimulates the adrenal and results in what
- bilateral nodular adrenocortical hyperplasia
gross difference between adrenal adenoma and carcioma
adenoma: encapsulated, yellow tumors
carinoma: larger
which adrenocortical neoplasm usually has non functional or functional adrenal gland
adenoma: nonfunctional
carcinoma: functional
what causes crooke’s hyaline
high levels of cortisol
what does the Dexamethasone test show for pituitary cushings
- low dose ACTH not suppressed
- high dose ACTH suppressed
what does the Dexamethasone test show for ectopic - ACTH cushing
neither high or low dose of Dexa suppresses
what does the Dexamethasone test show for adrenal cushing
- neither low or high dose suppresses
Primary hyperaldosteronism impacts what hormone
decreases renin
Secondary hyperaldosteronism impacts what hormone
increases renin
Presence of solitary aldosterone secreting adenoma is called what syndrome
Conn syndrome
what are sodium and potassium levels for hyperaldosteronism
sodium retention
potassium excretion
what gender gets hyperaldosteronism more frequently
females
what causes primary hyperaldosteronism
adenomas and/or hyperplasia