Flashcards in Adrenal Disease Deck (39)
What are the two main adrenal medullary tumours?
From which cells is Phaeochromocytoma derived?
Chromaffin cells of adrenal medulla
What do Phaeochromocytoma secrete?
Why is Phaeochromocytoma called the 10% tumour?
10% are extra-adrenal
10% are bilateral
10% are malignant
10% are not assoc. with hypertension
Which adrenal disorder is associated with dark/pigmented skin?
What are the main primary adrenal insufficiencies?
Congenital adrenal hyperplasia
What is the commonest cause of primary adrenal insufficiency?
Is Addison's disease an autoimmune condition?
Assoc. with autoantibodies in 70%
List clinical features of Addison's disease
Anorexia, weight loss
What would sodium and potassium levels be like in Addison's disease?
Which diagnostic test is used for Addison's disease?
Short synACTHen test
(give synthetic ACTH and measure cortisol levels)
Outline management of adrenal insufficiency
Fludrocortisone (replace aldosterone)
Patients on hydrocortisone for adrenal insufficiency can stop whenever they want. True/False?
Never stop suddenly but can reduce dose
List causes of secondary adrenal insufficiency
Exogenous steroid use (prednisolone)
What is the effect of exogenous steroid on the H-P-adrenal cortex axis?
Suppress CRH and ACTH
What hormone is in excess in Cushing's syndrome?
Cushing's syndrome is commoner in men. True/False?
List clinical features of Cushing's syndrome
Thin skin, easy bruising
What are the ACTH-dependent causes of Cushing's syndrome?
What are the ACTH-independent causes of Cushing's syndrome?
What is the gold-standard test for diagnosing Cushing's syndrome?
Low-dose dexamethasone suppression test
(0.5mg every 6hrs for 2 days; cortisol should be less than 50 in normal circumstances)
What is the commonest cause of cortisol excess?
High-dose steroid therapy (e.g. asthma, IBD)
What is primary aldosteronism?
Autonomous production of aldosterone, independent of its regulators
Which syndrome occurs due to aldosteronism?
What is the commonest cause of secondary hypertension?
Outline how an aldosterone excess is diagnosed
Measure aldosterone : renin ratio
If raised, do saline suppression test
Failure of aldosterone to suppress by 50% with 2L saline confirms aldosteronism
What are the main causes of aldosteronism?
Outline management of primary aldosteronism
Adrenalectomy if unilateral adenoma
Drug (spironolactone) if bilateral hyperplasia
What is the commonest cause of congenital adrenal hyperplasia?