EXAM #2: REVIEW Flashcards Preview

Endocrine > EXAM #2: REVIEW > Flashcards

Flashcards in EXAM #2: REVIEW Deck (91)
Loading flashcards...
1

What is the mnemonic to remember the parents vessels of the suprarenal arteries?

IPAR

Inferior phrenic= superior suprarenal a.
Aortic= middle suprarenal a.
Renal= inferior suprarenal a.

2

What is the expected gross finding in the setting of ACTH excess i.e. Cushing's? Be specific.

Hypertrophy of the adrenal cortex limited to the Fasiculata and Reticularis

3

What is the order in which the catecholamines are synthesized?

Tyrosine
DOPA
Dopamine
NE
Epi

4

What capillaries receive the hormones from the adrenal cortex?

Sinusoidal capillaries

5

What is the origin of the cortical and medullary arteries?

Supracapsular arterial plexus

6

Draw the synthesis pathway of the cortical steroids.

N/A

7

What are the physiologic actions of cortisol? What is the mnemonic to remember these actions?

Mnemonic= BIG FIB

B= Blood pressure increase
I= Insulin resistance
G= Gluconeogenesis, lipolysis, proteolysis
F= Fibroblast activity increased
I= Immunosuppression
B= Bone resorption

8

How does ACTH increase adrenal steroid synthesis?

Activation of the Melanocortin-2 Receptor

9

What is the function of 11β-HSD type II?

Inactivation of cortisol to corticosterone in mineralcorticoid rich tissues

10

What is the function of 11β-HSD type I?

Activation of corticosterone to cortisol in glucocorticoid rich tissue

11

How does cortisol increase blood glucose?

1) Increases gluconeogenesis
2) Decreases glucose utilization by cells

12

Where do adrenal carcinomas commonly metastasize?

1) Lungs
2) Lymph nodes

13

What are the two primary cortical neoplasms?

1) Cortical adenoma
2) Cortical carcinoma

14

How are cortical adenomas typically described grossly?

Well circumscribed, yellow-orange lesions

15

How are cortical adenomas typically described histologically?

Vacuolated with mild nuclear pleomorphism

16

What is the underlying pathology of Addison's Disease?

Chronic autoimmune destruction of the adrenal cortex

17

How will secondary adrenal insufficiency appear grossly?

Atrophy of the adrenal gland, with sparing of the Glomerulosa and Adrenal Medulla

18

What morphological features differentiate a cortical adenoma from a cortical carcinoma?

1) Metastasis
2) Large size
3) Necrosis
4) Mitotic figures
5) Vascular invasion

19

What are three clinical manifestations of a Neuroblastoma?

1) Abdominal mass
2) Diastolic hypertension
3) Blue-berry muffin baby

20

Describe the gross appearance of adrenal hyperplasia.

Yellow, thickened, and multinodular

21

What are the 10% rules of pheochromocytomas?

10% of pheochromocytomas are:
1) Bilateral
2) Familial
3) Malignant
4) Afunctional
5) Extraadrenal

22

Describe the gross appearance of a cortical carcinoma.

- Yellow on cut surface
- Large with areas of hemorrhage, cystic change, and necrosis

23

Describe the gross appearance of a pheochromocytoma.

- Pale gray-brown
- Associated with hemorrhage, necrosis, cystic change
- Highly vascular

24

Describe the morphology of the adrenal gland in Addison's Disease.

1) Small glands
2) Lipid depletion of the adrenal cortex
3) Variable lymphocytic infiltrate in the adrenal cortex

*Note that the adrenal medulla is SPARED

25

List six features of an adrenal tumor that are concerning for malignancy.

1) Irregular
2) Large (greater than 4cm)
3) Calcification
4) Unilateral
5) High CT attenuation (greater than 20 HU)
6) Extension into local structures

26

How is Conn Syndrome diagnosed?

1) Urine aldosterone
2) Saline suppression test

27

How is adrenal cancer treated?

Surgery if possible; otherwise, palliative measures

28

What do you need to remember about the clinical presentation of adrenal cancer?

B/c of local invasion, can have a mix of adrenal syndromes at presentation

29

If CT is equivocal in a patient with likely pheochromocytoma, what is the next best step?

Fluoroscope guided renal vein sampling

30

If you suspect an adrenal cancer in a patient, what labs should you check?

1) Cortisol
2) Catecholamines
3) Androgens