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Flashcards in Random Organ systems - endo Deck (105)
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91

What is the MCC of primary hyperaldosteronism? how is it characterized?

MCC is adrenal adenoma

high aldosterone & low renin (high flow)

92

What is the cause of secondary hyperaldosteronism? how is it characterized?

activation of RAAS => high aldosterone & high renin due to sensing less flow

93

Define congenital adrenal hyperplasia

excess sex steroids w/ hyperplasia of both adrenal glands

94

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

95

Differentiate 11 vs 21 hydroxylase deficiency

There will not be salt wasting in 11 deficiency

96

What is the findings in 17 deficiency?

excess mineralocorticoids;
no sex hormones so look like opposite of genotype;
excess ACTH

97

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

98

Define chronic adrenal insufficiency and give 3 MCC

progessive destruction of adrenal glands

AI destruction of adrenals;
TB;
metastatic CA

99

What cancer loves the adrenal?

lung

100

Why is hyper pigmentation assoc w/ adrenal insufficiency or any increase in ACTH?

ACTH is derived from POMC which makes melanocyte stimulating hormone

101

Where do the chrommafin cells of adrenals come from embryologically?

neural crest cells

102

How does a pheochromocytoma present grossly?

brown tumor due to chrommafin cells in adrenal medulla being brown

103

How is pheochromocytoma diagnosed?

increased serum metanephrines & 24 hr urine metanephrines & VMA

104

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

105

What are the genetic association of pheochromocytomas?

MEN 2A & B;
VHL disease;
NF type 1