Flashcards in Random Organ systems - endo Deck (105)
What is the MCC of primary hyperaldosteronism? how is it characterized?
MCC is adrenal adenoma
high aldosterone & low renin (high flow)
What is the cause of secondary hyperaldosteronism? how is it characterized?
activation of RAAS => high aldosterone & high renin due to sensing less flow
Define congenital adrenal hyperplasia
excess sex steroids w/ hyperplasia of both adrenal glands
What is the mechanism of pathology in 21 hydroxylase deficiency?
knock out mineral & gluco-corticoids leading to shunting to sex steroids (F: clit enlarge; M: precocious pub)
lack of cortisol will have life threatening hypoTN & excess ACTH (lack of inhibition) leading to hyperplasia of both adrenals;
Salt wasting & hyperkalemia & hypovolemic
Differentiate 11 vs 21 hydroxylase deficiency
There will not be salt wasting in 11 deficiency
What is the findings in 17 deficiency?
no sex hormones so look like opposite of genotype;
What is the acute cause of adrenal insufficiency?
waterhouse-friderichsen syndrome => N. meningitides after DIC then massive hypoTN
Look for sack of blood of adrenals
Define chronic adrenal insufficiency and give 3 MCC
progessive destruction of adrenal glands
AI destruction of adrenals;
What cancer loves the adrenal?
Why is hyper pigmentation assoc w/ adrenal insufficiency or any increase in ACTH?
ACTH is derived from POMC which makes melanocyte stimulating hormone
Where do the chrommafin cells of adrenals come from embryologically?
neural crest cells
How does a pheochromocytoma present grossly?
brown tumor due to chrommafin cells in adrenal medulla being brown
How is pheochromocytoma diagnosed?
increased serum metanephrines & 24 hr urine metanephrines & VMA
For the 10% of pheochromocytomas that are not in the adrenal medulla, where is the MC location? how will it present?
bladder wall => pt urinates causing HTNive episode