The Endocrine Syndrome: adrenal - Graffeo Flashcards Preview

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Flashcards in The Endocrine Syndrome: adrenal - Graffeo Deck (34):
1

What are 3 layers of the cortex and what do they secrete

Zona glomerulosa: cortisol and Al
Zona fasciculata: cortisol and andorgen
Zona reticularis: estrogens and androgens

2

what does the medulla secrete

catecholamines

3

What is the exogenous cause of hypercortisolism ( cushing)

Iatrogenic: caused by giving exogenous glucorticoids

4

What are endogenous causes of Cushings

1. primary hypothalamic-pituitary (increase ACTH)
2. primary adrenocortical neoplasm
3. secretion of ectopic ACTH

5

what is a most likely cause of ectopic ACTH by neuroendocrine tumors

small cell carcinoma of lung

6

what are early symptoms of cushings

hypertension
weight gain

7

what are late symptoms of cushings

truncal obesity
"moon" faces
"buffalo Hump"

8

How does cushings impact other organ systems

atrophy of fast twitch muscles (II)

9

Other symptoms of cushings

hyperglycemia
striae
poor wound healing
posterior neck adiposity

10

if cushings is caused by steroids then what happens to ACTH and adrenals.

decreased ACTH
atrophy of adrenal

11

due to endogenous causes in cushings what happens to the adrenal cortex

hyperplasia

12

Either pituitary ACTH or ectopic stimulates the adrenal and results in what

- bilateral nodular adrenocortical hyperplasia

13

gross difference between adrenal adenoma and carcioma

adenoma: encapsulated, yellow tumors
carinoma: larger

14

which adrenocortical neoplasm usually has non functional or functional adrenal gland

adenoma: nonfunctional
carcinoma: functional

15

what causes crooke's hyaline

high levels of cortisol

16

what does the Dexamethasone test show for pituitary cushings

- low dose ACTH not suppressed
- high dose ACTH suppressed

17

what does the Dexamethasone test show for ectopic - ACTH cushing

neither high or low dose of Dexa suppresses

18

what does the Dexamethasone test show for adrenal cushing

- neither low or high dose suppresses

19

Primary hyperaldosteronism impacts what hormone

decreases renin

20

Secondary hyperaldosteronism impacts what hormone

increases renin

21

Presence of solitary aldosterone secreting adenoma is called what syndrome

Conn syndrome

22

what are sodium and potassium levels for hyperaldosteronism

sodium retention
potassium excretion

23

what gender gets hyperaldosteronism more frequently

females

24

what causes primary hyperaldosteronism

adenomas and/or hyperplasia

25

what happens in clugocorticoid-supressible cause of hyperaldosteronism

derangement in zonation
- hybrid cells ( zona glomerulosa and zona fasiculata)

26

how do you treat adenoma hyperaldosteronism

surgical correction of hypertension

27

name two adrenogential syndromes

adrenocortical neoplasms
congenital adrenal hyperplasia

28

how is congenital adrenal hyperplasia inherited

autosomal recessive

29

what is the defect in congenital adrenal hyperplasia

21-hydroxylase deficiency
- decrease cortisol causes
- increase ACTH ( adrenocortical hyerplasia)

30

what are hormonal impacts from congenital adrenal hyperplasia

- decrease cortisol causes
- increase ACTH ( adrenocortical hyerplasia)
- increased androgen activity
- 1/3 Na wasting

31

what cultural groups get congenital adrenal hyperplasia

hispanics
Ashkenazi jews

32

increased ACTH in congenital adrenal hyperplasia causes what

bilateral nodular adrenal hyperplasia

33

how is congenital adrenal hyperplasia treated? what are the risks

exogenous glucocorticoids
- suppress ACTH
- risk of acute adrenal insufficiency

34

what composes the adrenal myelolipoma

fat and hematopoietic cells