Adrenal Path

Question 1

General and locational characteristics of the adrenal glands

Answer 1

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

Question 2

Three layers of cortex are

Answer 2

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

Question 3

Medulla produces

Answer 3

Epinephrine and noreepinephrine

Question 4

Origin of the cortex

Answer 4

mesoderm

Question 5

origin of the medulla

Answer 5

neuroectodermal

Question 6

Adrenal shape is determined by?

Answer 6

configuration of the surrounding organs

Question 7

Cushing syndrome’s most basic cause

Answer 7

Excess Cortisol!!!

Question 8

Cushing syndrome appearance

Answer 8

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

Question 9

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

Answer 9

ok

Question 10

Hyperaldosteronism by itself is most commonly due to what?

Answer 10

An aldosterone secreting cortical adenoma

Question 11

What do you call an Aldosterone secreting Cortical Adenoma

Answer 11

CONN SYNDROME

Question 12

Conn Syndrome characterized clinically by?

Answer 12

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

Question 13

Adrenogenital syndrome is what

Answer 13

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

Question 14

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

Answer 14

21-hydroxylase or 11-beta-hydroxylase

Question 15

21 hydroxylase has what effect on sodium?

Answer 15

wastes it

Question 16

11-beta-hydroxylase has what effect on sodium?

Answer 16

retains sodium

Question 17

Acute Adrenal insufficiency is what

Answer 17

A FUCKING NIGHTMARE

Question 18

prototype acute adrenal insufficiency?

Answer 18

Waterhouse Friderichsen Syndrome

Question 19

What is WFS

Answer 19

Overwhelming sepsis leading to 
DIC
Hypotension
Shock
Acute Adrenal failure

Question 20

What is the most common cause of WFS

Answer 20

N. Meningitidis

Question 21

Other causes of acute adrenal insufficiency

Answer 21

sudden withdrawal of exogenous corticosteroids

Question 22

Chronic Adrenal Insufficiency is known as

Answer 22

Addison’s Disease

Question 23

Addisonian pts have what symptoms

Answer 23

weakness, nausea, wt loss, hypotension

Question 24

What is a good sign that adrenal insufficiency is primary

Answer 24

High ATCH, demonstrated by hyperpigmentation

Question 25

Common for addison's disease pts to die suddenly

Answer 25

yes

Question 26

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

Answer 26

Osteoporosis due to lack of adrenals

Question 27

Most common causes of Addison's Disease

Answer 27

autoimmune adrenalitis, hemochromatosis

Question 28

Two possible neoplasms in the adrenal cortex are?

Answer 28

- Adrenal cortical adenoma | - Adrenal cortical carcinoma

Question 29

Two possible neoplasms in the medulla are?

Answer 29

- Neuroblastoma | - Pheochromocytoma

Question 30

Adrenal Cortical Adenoma

Answer 30

usually silent

Question 31

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

Answer 31

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

Question 32

Adrenal cortical carcinoma

Answer 32

rare. over 90% are functioning

Question 33

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

Answer 33

greater than 5cm or over 50grams

Question 34

Cortical neoplasms are what color

Answer 34

YELLOW>>>KNOW

Question 35

Most common extracranial tumor of childhood is

Answer 35

Neuroblastoma

Question 36

Most common site of a neuroblastoma

Answer 36

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

Question 37

Appearance (gross) of a neuroblastoma

Answer 37

Red in the center with a thin yellow capsule surrounding it

Question 38

Pheochromocytoma

Answer 38

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

Question 39

Adrenals are a common form of metastsis from:

Answer 39

lung, breast, others multifocal and bilateral = metastatic