Adrenal Disorders Flashcards Preview

MS2 - Digestive, Endocrine, and Metabolic Systems > Adrenal Disorders > Flashcards

Flashcards in Adrenal Disorders Deck (35):
1

Primary adrenal insufficiency results in loss of _________.

cortisol and aldosterone secretion

2

Secondary adrenal insufficiency results in loss of _____________.

cortisol only (aldosterone is preserved because it's controlled by angiotensin II)

3

_____________ is also called autoimmune adrenalitis.

Addison's disease

4

What five drugs can cause adrenal insufficiency?

Aminoglutethimide
Ketoconazole
Etomidate
Rifampin
Phenytoin

5

The most common cause of primary adrenal insufficiency is ____________ and secondary adrenal insufficiency is _____________.

Addison's disease; steroid use

6

Salt craving is a symptom of ___________ adrenal insufficiency.

primary (because aldosterone secretion is preserved in secondary adrenal insufficiency)

7

Adrenal crisis should be treated with ____________.

stress-dose steroids (100 mg every eight hours)

8

What three signs and symptoms occur only in primary adrenal insufficiency (as opposed to secondary)?

Hypotension
Hyperkalemia
Hyponatremia

9

Why does hyperpigmentation occur in primary adrenal insufficiency?

Because melanocyte-stimulating hormone and proopiomelanocortin are both breakdown products of POMC. If POMC is not broken down by the adrenal gland, then more is available to the melanocytes.

10

Half of the people with Addison's disease have at least _________________.

one other autoimmune disease

11

What cortisol levels – taken around 7 - 8 AM – suggest adrenal insufficiency?

Partial: 5 - 16 mg/dL
Complete: less than 5 mg/dL

12

If a person has suspiciously low cortisol levels, what should you do?

A cosyntropin test; less than 20 mg/dL 30-60 minutes after administration suggests adrenal insufficiency

13

In primary adrenal insufficiency, you need to replace ______________, while in secondary adrenal insufficiency you only need to replace ___________.

both glucocorticoids and mineralocorticoids; glucocorticoids

14

What is AVS?

Adrenal vein sampling

15

Licorice intake can lead to _______________.

pseudohypercortisolism

16

Plasma metanephrines should be drawn after ______________.

twenty minutes' rest

17

The vast majority of adrenal incidentalomas are ______________.

non-functional

18

Cortisol is necessary for ____________ balance.

cardiovascular (in adrenal insufficiency, people get hypovolemia and hypotension)

19

The most common cause of primary adrenal insufficiency in the U.S. is ___________, while worldwide it is ______________.

Addison's (autoimmune destruction); TB

20

The best way to diagnose adrenal insufficiency is _____________.

Cortrosyn stimulation; you measure cortisol 30 minutes and 60 minutes after administering Cortrosyn (synthetic ACTH). Levels greater than 20 ug/dl indicate adequacy of adrenal reserves

21

The most common cause of primary hyperaldosteronism is ___________, followed by _____________.

idiopathic; adrenal adenoma

22

These clinical signs should raise suspicion for primary hyperaldosteronism: _______________.

treatment-refractory hypertension, hypokalemia, and young age at onset

23

The best diagnostic for primary hyperaldosteronism is a ___________ test.

aldosterone suppression (in which saline is given and then aldosterone levels measured)

24

What differentiates MEN 2A and MEN 2B?

Both are mutations in the ret gene and present with pheochromocytoma and medullary thyroid carcinoma, but 2A presents with hyperparathyroidism (which has two A's) while 2B presents with mucosal neuromas.

25

What triad of symptoms does pheochromocytoma present with?

Diaphoresis, palpitations, and headaches

26

The preferred lab test for diagnosing pheochromocytoma is _______________.

24-hour urine metanephrines

27

The most common cause of Cushing's is iatrogenic, but the second most common cause is ________________.

ACTH-secreting adenoma

28

________________ is also called Conn's syndrome.

Primary hyperaldosteronism

29

Why does licorice cause pseudohyperaldosteronism?

Licorice inhibits the enzyme that converts cortisol to cortisone, thereby raising the levels of cortisol. This binds to the aldosterone receptor and leads to similar symptoms of high aldosterone levels.

30

Metyrapone is a __________________.

cortisol synthesis inhibitor

31

What can affect metanephrine level?

Acetaminophen, SSRIs, marijuana, and SNRIs

32

In addition to metanephrines, ______________ is another good lab indicator of pheochromocytoma.

vanillylmandelic acid

33

About half of pheochromocytomas are __________.

hereditary (more if the presentation occurs in childhood)

34

Which chromosome does the Ret gene lie on?

10 (MEN = ten)

35

What is a good way on imaging to predict an adrenal adenoma's prognosis?

Houndsfield units: less than 10 is suggestive of benign

Decks in MS2 - Digestive, Endocrine, and Metabolic Systems Class (133):