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Endo/Repro Exam 2 > Adrenal Pathology > Flashcards

Flashcards in Adrenal Pathology Deck (37):
1

What are the adrenocortical hyperfunctioning diseases?

Hypercortisolism (Cushing)
Hyperaldosteronism
Adrenogenital syndromes (Virilization)

2

What are the adrenocortical hypofunctioning disease?

Primary acute adrenocortical insufficiency
Primary chronic adrenocortical insufficiency
Secondary adrenocortical insufficiency

3

What are the two types of hypercortisolism?

Exogenous
Endogenous

4

Two types of endogenous hypercortisolism?

ACTH-dependent
ACTH-independent

5

What is hypercortisolism also know as?

Cushing syndrome

6

What occurs to the adrenal gland in exogenous Cushing syndrome and why?

Adrenocortical atrophy
The exogenous glucocorticoids are inhibiting ACTH release and therefore the adrenal cortex is not creating glucocorticoids and wastes away

7

What is endogenous ACTH-dependent Cushing syndrome?

ACTH driven cortisol production

8

What are potential causes of ACTH-dependent Cushing syndrome?

Pituitary adenoma
Ectopic ACTH (small cell lung carcinoma)

9

What is a pituitary adenoma causing hypercortisolism called?

Cushing disease

10

What causes ACTH-independent hypercortisolism?

Autonomous cortisol production
Adrenocortical neoplasms

11

What occurs to the size of the adrenal glands in ACTH-independent hypercortisolism?

Contralateral adrenal gland atrophy due to the affected adrenal gland creating cortisol which then inhibits ACTH release

12

Do adenomas or carcinomas of the adrenal gland cause more cortisol production?

Carcinomas

13

What occurs to the diurnal pattern of serum cortisol in Cushing syndrome?

Loss of the diurnal pattern

14

What is seen in the urine of Cushing syndrome patients?

Urinary excretion of 17-hydroxycorticosteroids

15

What does dexamethasone (DXM) do?

Inhibits release of ACTH from pituitary

16

What are the expected values of ACTH when low and high does of DXM are administered to a Cushing disease patient?

Low: no change
High: decrease ACTH release

17

What occurs in primary hyperaldosteronism?

Autonomous overproduction of aldosterone

18

What is the status of renin in hyperaldosteronism?

Decreased plasma renin levels

19

Three causes of primary hyperaldosteronism:

1.) Bilateral idiopathic hyperaldosteronism
2.) Aldosterone-producing adenoma
3.) Glucocorticoid-remediable hyperaldosteronism

20

What is Conn syndrome?

Aldosterone producing adenoma

21

What causes glucocorticoid-remediable hyperaldosteronism?

Familial genetics that causes aldosterone synthase to be responsive to ACTH when it typically is not; this means that ACTH will cause an increase in aldosterone and aldosterone does not feedback to inhibit ACTH

22

How is glucocorticoid-remediable hyperaldosteronism treated?

Glucocorticoids
DXM
Both will inhibit release of ACTH from pituitary gland

23

Two primary causes of excess adrenal androgens:

1.) Adrenocortical neoplasms
2.) Congenital adrenal hyperplasia

24

Why does mixed syndrome occur with adrenocortical neoplasms?

Because they are often caused by adenomas which are grow into the basement membrane into other zones of the adrenal gland and cause hypercortisolism

25

What is seen with adrenocortical neoplasms?

Decreased ACTH and hypercortisolism

26

Most common cause of congenital adrenal hyperplasia?

21-hydroxylase deficiency

27

What is seen in CAH?

Increased ACTH
Increased androgens
Decreased glucocorticoids

28

What is primary chronic adrenocortical insufficiency known as?

Addison disease

29

What causes primary acute adrenocortical insufficiency?

Rapid withdrawal of exogenous steroids
Massive bilateral adrenal hemorrhage

30

What is a disseminated bacterial infection to the adrenal glands known as?

Waterhouse-Friderichsen syndrome

31

What bacteria typically cause Waterhouse-Friderichsen syndrome?

Neisseria mengitides

32

What can cause primary chronic adrenocortical insufficiency?

Autoimmune adrenalitis
Tuberculosis
AIDS: CMV
Metastatic cancers

33

What does POMC stand for?

Pro-opiomelanocortin

34

What is POMC?

A precursor that is cleaved into ACTH and MSH

35

What does MSH cause?

Increase in pigmentation

36

What is the relationship between potassium and sodium in the kidneys?

They are found in inverse relations since they are both cationic if sodium is secreted then potassium is absorbed

37

Why does skin hyperpigmentation not occur in secondary adrenocortical insufficiency?

Because ACTH is not secreted therefore MSH is not either