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Flashcards in Adrenal Path Deck (39):
1

General and locational characteristics of the adrenal glands

Retroperitoneal, superomedial to the kidneys, each weighs 4-5 grams

2

Three layers of cortex are

Zona Glomerulosa- mineralocorticoids- aldosterone
Zona Folliculosa- glucocoricoids- Cortisol
Zona Reticularis- Sex hormones

3

Medulla produces

Epinephrine and noreepinephrine

4

Origin of the cortex

mesoderm

5

origin of the medulla

neuroectodermal

6

Adrenal shape is determined by?

configuration of the surrounding organs

7

Cushing syndrome's most basic cause

Excess Cortisol!!!

8

Cushing syndrome appearance

moon fascies, buffalo hump, truncal obesity, edema, hypertension, bruisability, hunger, gastric ulcers, thin skin

9

Know how to differentiate Cushing's Disease from Cushing's Syndrome

ok

10

Hyperaldosteronism by itself is most commonly due to what?

An aldosterone secreting cortical adenoma

11

What do you call an Aldosterone secreting Cortical Adenoma

CONN SYNDROME

12

Conn Syndrome characterized clinically by?

hypertension and hypokalemia...because aldosterone increases Na reabsorption but decreases K

13

Adrenogenital syndrome is what

When there is some difficulty synthesizing cortisol which causes a lack of feedback inhibition to the hypothalamus and pituitary leading eventually to adrenal hyperplasia and increased synthesis of androgens like testosterone

14

What are the two enzymes most frequently deficient in Androgenital syndrome?

21-hydroxylase or 11-beta-hydroxylase

15

21 hydroxylase has what effect on sodium?

wastes it

16

11-beta-hydroxylase has what effect on sodium?

retains sodium

17

Acute Adrenal insufficiency is what

A FUCKING NIGHTMARE

18

prototype acute adrenal insufficiency?

Waterhouse Friderichsen Syndrome

19

What is WFS

Overwhelming sepsis leading to
DIC
Hypotension
Shock
Acute Adrenal failure

20

What is the most common cause of WFS

N. Meningitidis

21

Other causes of acute adrenal insufficiency

sudden withdrawal of exogenous corticosteroids

22

Chronic Adrenal Insufficiency is known as

Addison's Disease

23

Addisonian pts have what symptoms

weakness, nausea, wt loss, hypotension

24

What is a good sign that adrenal insufficiency is primary

High ATCH, demonstrated by hyperpigmentation

25

Common for addison's disease pts to die suddenly

yes

26

What is severe in post-menopausal women with Addison's

Osteoporosis due to lack of adrenals

27

Most common causes of Addison's Disease

autoimmune adrenalitis, hemochromatosis

28

Two possible neoplasms in the adrenal cortex are?

-Adrenal cortical adenoma
-Adrenal cortical carcinoma

29

Two possible neoplasms in the medulla are?

- Neuroblastoma
- Pheochromocytoma

30

Adrenal Cortical Adenoma

usually silent

31

If an adrenal cortical adenoma is functional, the gland adjacent and opposite to it is?

atrophic.....if the adenoma is non-functional, the gland opposite is normal

32

Adrenal cortical carcinoma

rare. over 90% are functioning

33

What dimensions make an adrenal cortical carcinoma a likely candidate for metastasis

greater than 5cm or over 50grams

34

Cortical neoplasms are what color

YELLOW>>>KNOW

35

Most common extracranial tumor of childhood is

Neuroblastoma

36

Most common site of a neuroblastoma

adrenals and paraaortic ganglia...may occur anywhere in SNS

37

Appearance (gross) of a neuroblastoma

Red in the center with a thin yellow capsule surrounding it

38

Pheochromocytoma

the 10% neoplasms
10% are:
-familial
-extradrenal
-bilateral
-malignant
-in childhood

39

Adrenals are a common form of metastsis from:

lung, breast, others

multifocal and bilateral = metastatic