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Flashcards in Adrenal Pathology Deck (40):
1

What three disorders of the adrenal gland cause too much hormones?

Cushing syndrome
Hyperaldosteronism
Adrenogenital syndrome

2

What tests are used to diagnose Cushing Syndrome?

24 hour urine free cortisol
Loss of normal diurnal cortisol secretion
ACTH level
Dexamethasone suppression test

3

What is the most common cause of Cushing syndrome?

Iatrogenic Cushing
(Drugs caused)

4

What do Cortisol/ACTH tests look like for Iatrogenic Cushing Syndrome?

Increased Cortisol
Decreased ACTH

5

What is the most common endogenous cause of Cushing syndrome?

Cushing Disease

6

What do Cortisol/ACTH levels look like for Cushing Disease?

Cortisol increased
ACTH increased

7

What happens to cortisol levels with a high-dose dexa test in Cushing disease?

Supresses

8

What are causes of adrenal cushing syndrome?

Adenoma, hyperplasia, carcinoma

9

What are Cortisol/ACTH levels for Adrenal Cushing Syndrome?

Increased cortisol
Decreased ACTH

10

What happens to cortisol levels with a high-dose dexa test in Adrenal cushing syndrome?

No suppression

11

What is the most common cause of paraneoplastic cushing syndrome?

SCC of the lung

12

What are Cortisol/ACTH levels for paraneoplastic Cushing syndrome?

Increased cortisol
Increased ACTH (fake)

13

What happens to cortisol levels with a high-dose dexa test in paraneoplastic Cushing syndrome?

No suppression

14

What are the main effects of aldosterone?

Retain Na and H2O
Pee out K

15

What are symptoms of hyperaldosteronism?

Hypertension
Hypokalemia (weakness, fatigue, psychosis)

16

What are common lab findings of primary hyperaldosteronism?

Elevated Aldosterone
Low Renin
Hypernatremia
Hypokalemia
Metabolic alkalosis

17

What are the most common causes of primary hyperaldonism?

Cortical adenoma (Conn Syndrome)
Cortical hyperplasia

18

What are the common causes of secondary hyperaldosteronism?

Anything that increases renin
CHF\
Decreased renal blood flow
Renin producing tumors

19

What are the lab findings of secondary hyperaldosteronism?

Same as primary with HIGH renin

20

If you have a patient with SUDDEN virilization, what is likely the problem?

Adrenocortical carcinoma

21

What does adrenocortical carcinoma look like grossly?

Necrotic, ugly tumor

22

What's the prognosis like for adrenocortical carcinoma?

Bad.

23

What's the most common cause of congenital adrenal hyperplasia?

21-hydroxylase deficiency

24

What is the result of 21 hydroxylase deficiency?

Decreased cortisol and aldosterone
Increased sex steroids

25

What is Addison disease?

Primary chronic adrenal insufficiency

26

What is the cause of Addison disease?

Usually autoimmune

27

What are symptoms of Addison disease?

Weakness, fatigue, GI complaints
Hypotension
Skin hyperpigmentation

28

What are causes of primary acute adrenal insufficiency?

Addisonian crisis
Rapid steroid withdrawal
Massive adrenal hemorrhage

29

When do you see massive adrenal hemorrhage?

Neisseria infection in an infant

30

What is Waterhouse-Friderichsen syndrome?

The neisseria infection of an infant

31

What does Waterhouse Friderichsen syndrome look like?

Hypotension, shock
DIC
Massive bilateral adrenal hemorr.
Rapidly progressive

32

What are the most common causes of secondary adrenal insufficiency?

Pituitary or hypothalmic insufficiency
Tumor, infection, radiation, infarction

33

What does secondary adrenal insufficiency look like?

Symptoms of decreased cortisol and decreased sex steroids
Mineralocorticoids normal because Renin axis is intact

34

What are the 10%'s of a Pheochromocytoma?

10% extra-adrenal
10% bilateral
10% (or more) familial
10% malignant
10% don't have hypertension

35

What is a pheochromocytoma?

Neoplasm of catecholamine producing cells

36

What do you look for in the urine if you suspect pheochromocytoma?

Catecholamines
VMA
Metanephrines

37

What are symptoms of pheochromocytoma?

Pressure (BP inc)
Pain (Headache)
Perspiration
Palpitations (tachy)
Pallor
Paroxysms

38

More copies of this gene cause a worse prognosis in neuroblastoma.

N-myc

39

Who commonly gets neuroblastomas?

children

40

What are often seen on slide examination for neuroblastomas?

Homer-wright rosettes