Adrenal condensed Flashcards Preview

Endocrinology > Adrenal condensed > Flashcards

Flashcards in Adrenal condensed Deck (12):
1

Where are mineralocortiocoid receptors?

Kidneys, gut and glands (sweat and salivary)

2

Dark skin
Dehydrated
Hypotensive
 Na K
Weight loss
Amenorrhea

Decreased Na+
Increased K+
(addisons)

3

Causes of adrenal insufficiency (primary and secondary)

Primary insufficiency
Addison’s disease
Congenital Adrenal Hyperplasia (CAH)
Adrenal TB/malignancy
Secondary insufficiency
Due to lack of ACTH stimulation
Iatrogenic (excess exogenous steroid)
Pituitary/hypothalamic disorders

4

Autoimmune diseases associated with Addisons

Type 1 DM, autoimmune thyroid disease, pernicious anaemia

5

Diagnosis of adrenal insufficiency

‘Suspicious biochemistry’
low Na, high K
hypoglycaemia
SHORT SYNACTHEN TEST
Measure plasma cortisol before and 30 minutes after iv ACTH injection
Normal: baseline >250nmol/L, post ACTH >480
ACTH levels
Should be  (causes skin pigmentation)
Renin/aldosterone levels
 renin  aldosterone
Adrenal autoantibodies

6

Prolactinoma symptoms

Infertility
Lack of libido
Amenorrhea

7

Tumour derived from the remnants of Rathke's pouch?

Craniopharyngioma
(headache, visual disturbances, hypopituitarism)

8

What do neuroendocrine cells secrete?

Catecholamines

9

Features suggesting adrenocortical carcinoma?

Large size (>50g, often >20cm)
Haemorrhage and necrosis
Frequent mitoses, atypical mitoses
Lack of clear cells
Capsular or vascular invasion

10

In phaeochromoctyoma, what might cause a paroxysmal episode of hypertension?

-Stress
-Exercise
-Posture
-Palpation of tumour (e.g. feeling the tummy can cause release of adrenaline)

11

Sipple syndrome

MEN2A

12

Phaeochromocytoma (40-50%), Medullary thyroid carcinoma (100%), parathyroid hyperplasia (10-20%)
Phaeochromocytoma may be bilateral and occur at extra-adrenal sites
Linked to germline gain of function mutation in RET oncogene on chromosome 10q11.2 (ie constitutively activated)

MEN2A (Sipple syndrome)