adrenal endocrine diseases (clinical)

Question 1

what is pheochromocytoma?

Answer 1

a tumour of the adrenal medulla / preganglionic sympathetic neurones

Question 2

what does a pheochromocytoma do?

Answer 2

it secretes adrenaline and noradrenaline uncontrollably, causing blood pressure to increase greatly

Question 3

how will patients with pheochromocytoma present?

Answer 3

palpitations, (profuse sweating) diaphoresis, headaches

Question 4

what can be used to treat pheochromocytoma?

Answer 4

phenoxybenzamine

Question 5

how does phenoxybenzamine work?

Answer 5

it is a competitive, irreversible antagonist of adrenaline
can be used to reduce blood pressure
binds to adrenaline receptors, making less receptors available for adrenaline to bind to

Question 6

What is Addison’s disease characterised by?

Answer 6

low cortisol and aldosterone levels

Question 7

Why is Addison’s disease characterised by low cortisol and aldosterone levels?

Answer 7

autoimmune destruction of adrenal cortex

Question 8

what can exacerbate Addison’s disease? what can it lead to?

Answer 8

Stress may exacerbate the condition, producing an Addisonian crisis

Question 9

how do you treat Addisonian crisis?

Answer 9

treat urgently with IV cortisol and administration of dextrose in normal saline as fluid replacement, in order to prevent death

Question 10

what is Cushing’s syndrome?

Answer 10

signs and symptoms associated with chronically elevated cortisol levels in the blood

Question 11

what are the signs and symptoms of Cushing’s syndrome?

Answer 11

Moon shaped face and buffalo hump
Thin skin and easy bruising - proteins in skin broken down
Hyperglycaemia
Hypertension
(all due to raised cortisol)

Question 12

when is high glucocorticoid levels known as Cushing’s disease?

Answer 12

If the anterior pituitary gland is the cause (e.g pituitary adenoma)