Path 11 Schneider Flashcards Preview

Test 9 > Path 11 Schneider > Flashcards

Flashcards in Path 11 Schneider Deck (30)
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1
Q

Cushing disease

A

Only pituitary adenoma/microadenomas -> ACTH

2
Q

Most common ectopic ACTH production

A

Small cell lung CA

3
Q

Dexamethasone suppression test

A

Won’t suppress ectopic ACTH or Hypercorticism Autonomous

4
Q

Cushing disease morphologic change

A

Bilateral hyperplasia of adrenal Zona Fasciculata

-Atrophy in C syndrome

5
Q

Cushing syndrome clinical appearance

A
  • Moon facies
  • Central obesity
  • Abdominal striae (skin atrophy)
  • Osteoporosis
  • Muscle wasting
  • Emotional disturbance
6
Q

Conn syndrome

A

Primary aldosteronism

7
Q

Primary aldosteronism causes

A

Adrenocortical adenoma (aldosteronoma)

  • Zona Glomerulosa hyperplasia (less)
  • Adrenocortical carcinoma (least)
8
Q

Primary aldosteronism clinical (4)

A
  • HTN
  • Hypokalemia
  • Sodium and water retention
  • Decreased serum Renin
9
Q

Secondary aldosteronism causes

A
  • Renal ischemia/tumor

- Profound edema (cirrhosis, CHF, neprhotic syndrome)

10
Q

Secondary aldosteronism mechanism

A

Renin-angiotensin stimulation

-Serum renin increased (opposite of primary aldosteronism)

11
Q

Primary v secondary aldosteronism

A
  • Unilateral v bilateral ZG hyperplasia

- Decreased v increased serum Renin

12
Q

Adrenal virilism

A

Congenital cortisol enzyme defect -> ACTH compensation -> adrenal hyperplasia -> adrogenic steroid production

13
Q

Adrenal virilism enzyme

A

21-hydroxylase deficiency (salt wasting form -> hypotension)

11-hydroxylase deficiency (less common, salt retention -> HTN)

14
Q

21-hydroxylase function

A

17-hydroxyprogesterone -> 11-deoxycortisol

15
Q

21-hydroxylase deficiency

A

17-hydroxyprogesterone -> androstenedione

16
Q

Adrenal virilism morphology

A

Zona Reticularis adenoma, carcinoma, hyperplasia

17
Q

Pituitary deficiency

A

Secondary adrenal failure - No ACTH

-No hyperpigmentation - No B-MSH

18
Q

Addison disease

A

Primary adrenocortical deficiency

-Autoimmune or tuberculosis

19
Q

Addison clinical

A
  • Hypotention
  • Hyperpigmentation
  • Decreased electrolytes except potassium
20
Q

Tuberculosis histo

A

Caseating granuloma

Langhans giant cell

21
Q

Waterhouse-Friderichsen syndrome (3)

A

Catastrophic adrenal insufficiency & vascular collapse

  • Meningococcal meningitis
  • Hemorrhagic necrosis of adrenal cortex due to DIC
22
Q

Adrenal cortical adenoma

A

Loss of function?

23
Q

Chromaffin cell tumors

A

Adrenal - Pheochromocytoma

Extra-adrenal - Paraganglioma

24
Q

Pheochromocytoma

A

Surgically correctable HTN

  • due to catecholamine hyperproduction
  • usually benign
25
Q

Pheochromocytoma test

A

Urine vanillylmandelic acid

  • metanephrine
  • normetanephrine
26
Q

Pheochromocytoma EM

A

Membrane-bound secretory granules (black)

27
Q

Neuroblastoma

A

Malignant childhood catecholamine tumor

-“Small blue cell” tumor

28
Q

Neuroblastoma origin

A

Adrenal medulla

29
Q

Neuroblastoma presentation

A

Large abdominal mass

-HTN

30
Q

Neuroblastoma cause

A

N-myc oncogene amplification

  • Copy number related to aggressiveness
  • Occasionally converts into benign ganglioneuroma