Adrenal disorders Flashcards Preview

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Flashcards in Adrenal disorders Deck (13):

Causes of primary adrenal insufficiency

AI adrenalitis, TB, amyloidosis, hemochromatosis, bilateral adrenalectomy, adrenal vein thrombosis, adrenal artery embolus, metastatic carcinoma


Causes of secondary adrenocortical insufficiency

hypopituitarism (sheehan, chromophobe adenoma, hypophysectomy) Optic gliomas, craniopharyngiomas, basal meningitis, stalk section, tumors of 3rd ventricle, encephalitis, trauma, corticosteroid administration


What symptoms should you look for in chronic adrenal insufficiency?

1. weakness
2. pigmentation of skin and mucous membranes
3. Weight loss
4. hypotension
5. Anorexia, N/V
6. Salt craving
8. Syncopal episodes
9. Vitiligo


What symptoms should you look for in acute adrenal insufficiency?

1. hypotension
2. N/V
3. Collapse
4. Hyperthermia
5. Hypoglycemia
6. Hyponatremia, hyperkalemia


What are causes of ACTH-dependent Cushing's syndrome?

Cushing's disease, ectopic ACTH syndrome, ectopic CRH syndrome


ACTH independent cushings syndrome causes

adrenal adenoma, adrenal carcinoma, micronodular hyperplasia, macronodular hyperplasia


Causes of pseudo-cushincs syndrome

major depressive disorder, alcoholism


Biochemical tests for presence or absence of cushing's syndrome.

Circardian rhythm or plasma cortisol, low dose dexamethasone suppression, 24 hr urinary free cortisol, salivary cortisol determination


What test differentiates patients with Cushings syndrome of any cause from pt who do not have Cushings.

Low dose- dexamethasone


What biochemical tests are used for etiology of established Cushings?

high dose dexamethasone suppression. Plasma ACTH immunoassay, metyrapone test, CRH stimulation +/- petrosal sinus cath


Describe what a dexamethasone distinguishes between and how.

Pt with cushings disease from pt with ectopic ACTH syndrome and from those with adrenal tumors producing excess cortisol. This is because a pituitary tumor producing ACTH will usually respond to exogenous GC if a high enough dose is give.


What will happen with pt with Cushing's disease in a high dose dexamethasone test



More than half of all pt require only 3 tests to determine that they have cushings disease:

24 hour urine cortisol, measurement of plasma cortisol and ACTH, high dose dex suppression test