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D&T 4 exam 1 > The Endocrine Syndrome: adrenal - Graffeo > Flashcards

The Endocrine Syndrome: adrenal - Graffeo Flashcards

1
Q

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

A

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

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2
Q

what does the medulla secrete

A

catecholamines

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3
Q

What is the exogenous cause of hypercortisolism ( cushing)

A

Iatrogenic: caused by giving exogenous glucorticoids

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4
Q

What are endogenous causes of Cushings

A
  1. primary hypothalamic-pituitary (increase ACTH)
  2. primary adrenocortical neoplasm
  3. secretion of ectopic ACTH
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5
Q

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

A

small cell carcinoma of lung

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6
Q

what are early symptoms of cushings

A

hypertension

weight gain

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7
Q

what are late symptoms of cushings

A

truncal obesity
“moon” faces
“buffalo Hump”

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8
Q

How does cushings impact other organ systems

A

atrophy of fast twitch muscles (II)

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9
Q

Other symptoms of cushings

A

hyperglycemia
striae
poor wound healing
posterior neck adiposity

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10
Q

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

A

decreased ACTH

atrophy of adrenal

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11
Q

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

A

hyperplasia

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12
Q

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

A
  • bilateral nodular adrenocortical hyperplasia
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13
Q

gross difference between adrenal adenoma and carcioma

A

adenoma: encapsulated, yellow tumors
carinoma: larger

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14
Q

which adrenocortical neoplasm usually has non functional or functional adrenal gland

A

adenoma: nonfunctional
carcinoma: functional

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15
Q

what causes crooke’s hyaline

A

high levels of cortisol

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16
Q

what does the Dexamethasone test show for pituitary cushings

A
  • low dose ACTH not suppressed

- high dose ACTH suppressed

17
Q

what does the Dexamethasone test show for ectopic - ACTH cushing

A

neither high or low dose of Dexa suppresses

18
Q

what does the Dexamethasone test show for adrenal cushing

A
  • neither low or high dose suppresses
19
Q

Primary hyperaldosteronism impacts what hormone

A

decreases renin

20
Q

Secondary hyperaldosteronism impacts what hormone

A

increases renin

21
Q

Presence of solitary aldosterone secreting adenoma is called what syndrome

A

Conn syndrome

22
Q

what are sodium and potassium levels for hyperaldosteronism

A

sodium retention

potassium excretion

23
Q

what gender gets hyperaldosteronism more frequently

A

females

24
Q

what causes primary hyperaldosteronism

A

adenomas and/or hyperplasia

25
Q

what happens in clugocorticoid-supressible cause of hyperaldosteronism

A

derangement in zonation

- hybrid cells ( zona glomerulosa and zona fasiculata)

26
Q

how do you treat adenoma hyperaldosteronism

A

surgical correction of hypertension

27
Q

name two adrenogential syndromes

A

adrenocortical neoplasms

congenital adrenal hyperplasia

28
Q

how is congenital adrenal hyperplasia inherited

A

autosomal recessive

29
Q

what is the defect in congenital adrenal hyperplasia

A

21-hydroxylase deficiency

  • decrease cortisol causes
  • increase ACTH ( adrenocortical hyerplasia)
30
Q

what are hormonal impacts from congenital adrenal hyperplasia

A
  • decrease cortisol causes
  • increase ACTH ( adrenocortical hyerplasia)
  • increased androgen activity
  • 1/3 Na wasting
31
Q

what cultural groups get congenital adrenal hyperplasia

A

hispanics

Ashkenazi jews

32
Q

increased ACTH in congenital adrenal hyperplasia causes what

A

bilateral nodular adrenal hyperplasia

33
Q

how is congenital adrenal hyperplasia treated? what are the risks

A

exogenous glucocorticoids

  • suppress ACTH
  • risk of acute adrenal insufficiency
34
Q

what composes the adrenal myelolipoma

A

fat and hematopoietic cells

D&T 4 exam 1 (17 decks)

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