Friday - Adrenal Path and MEN - Krafts Flashcards Preview

Josh Endo week 1 > Friday - Adrenal Path and MEN - Krafts > Flashcards

Flashcards in Friday - Adrenal Path and MEN - Krafts Deck (27):
1

Cushing syndrome is due to what?

Too much cortisol

2

Actions of Cortisol

blood pressure
breaks down bone
suppress inflammation and immune function
gluconeogenesis

bbiig

3

Sx of cushing's syndrome

hypertension, weight gain
- habitus (toro, moon face, buffalo hump)
weakness
infections
mental changes

4

Labs for Cushing's

24 hour cortisol

ACTH level - can be high or low, just shows cause
dexamethasone suppression test - give it and measure cortisol -

5

Pituitary Cushing syndrome happens how

Adenoma that makes ACTH --> cortisol

6

When is the dexamethasone test helpful?

figure out if it's pituitary adenoma causing the cushings. dexamethasone at high doses with make the tumor stop secreting

adrenal tumor secreting cortisol wouldn't respond

7

Cushing syndrome due to tumor. Didn't respond to dexamethasone.
what two things could it be from? how do you distinguish between them?

Adrenal tumor or paraneoplastic (small cell lung carcinoma)

paraneoplastic has rise in ACTH, but it's like a fake ACTH

8

common cause of hyperaldosteronism

cotical adenoma of the adrenals --> ald --> decrease renin

9

Symptoms of hyperaldoseronism

hypertension
weakness/fatigue

10

lab findings of primary hyperaldoseronism

increased aldosterone
decreased renin
hypernatremia
hypokalemia

11

Secondary hyperaldosteronism labs
due to?

increased renin and aldosterone

decreased blood flow from a renin making tumor

12

what is virilization

a girl that gets swoll and many characteristics like lots of hair.
due to too many androgens

13

Sudden virilization can be from what tumor

adrenocortical carcinoma
- bad prognosis

14

most common hydroxylase deficiency and labs
Cortisol, Aldosterone
Sex seteroids

21 hydroxylase
decreased cort and ald
increased sex steroids

15

name for primary chronic adrenal insufficiency

cause
symptoms

addison's disease

autoimmune

weakness, hypotension and skin pigmentation

16

waterhouse friderichsen syndrome

It's a primary adrenal insufficiency
neisseria --> adrenal hemorrhage --> hypotension, shock.
rapid

17

Secondary renal insufficiency due to:

decreased ACTH
- from pituitary insufficiency
- tumor, infection, radiation

18

Pheochromocytoma
cells make:

catecholamines
--> hypertension

19

Symptoms of pheochromocytoma

high BP
headache
sweating
tachycardia
paroxysmal

20

histo of pheochromocytoma

not much
large nuclei
"zellballen" - balls of tumor

21

neuroblastoma is from what
common in what pop
prognosis good if:
lab finding (first aid)

neural crest
children
younger than 18 mo
fewer copies of n-myc
increased dopamine breakdown product in urine (homovanillic acid)

22

histo of neuroblastoma

rosettes (homer-wright)

23

MEN1 also called:
where do you get tumors

Wermer syndrome
parathyroid hyperplasia
- stones
pancreatic tumors
- gastrinoma, insulinoma
pituitary adenoma

24

MEN1 gene codes for what?
mutation does what

menin
turns gene off (tumor suppressor gene)

25

MEN2A tumors

medullary thyroid carcinoma
pheochromocytoma
parathyroid hyperplasia

26

MEN2A gene

what kind of receptor
mutation does what?

RET gene mutation
proto-oncogene
tyrosine kinase receptor
turns gene on

27

MEN2B manifestations not seen in 2A

oral
marfanoid looking