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Endocrine: Adrenals
Set 2
22
Medical
Professional
01/27/2008

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Cards

Term
What is the most common cause of isolated, non-medication related aldosterone deficiency?
Definition
Hyporeninemic hypoaldosteronism. It is related to diabetic nephropathy.
Term
What is the major clinical concern in patients with aldosterone deficiency?
Definition
Hyperkalemia.

Harmful effects include cardiac asystole. Kyperkalemia may be treated with furosemide or flucortisone.
Term
Which hormone deficiency is responsible for the predominant clinical manifestations of adrenal insufficiency?
Definition
Cortisol
Term
Which is more common, primary or secondary adrenal insufficiency, and why?
Definition
Secondary adrenal insuffiency is more common because of iatrogenic reasons. Glucocorticoids given as anti-inflammatory medication are the specific cause.
Term
What is the most common cause of chronic adrenal insufficiency (Addison's Disease)?
Definition
Autoimmune adrenalitis
Term
What are the genetics of APECED syndrome?
Definition
Autosomal recessive mutation of AIRE gene on chromosome 21
Term
What is waterhouse-friderickson syndrome?
Definition
Adrenal hemorrhage in the context of bacterial sepsis.
Term
What are the top 2 risk factors for adrenal hemorrhage?
Definition
1. Anticoagulation therapy
2. DIC associated with sepsis
Term
What is the leading cause of acute primary adrenal insufficiency?
Definition
Adrenal Apoplexy (bilateral massive spontaneous adrenal hemorrhage)
Term
What is the most common cause of congenital adrenal hyperplasia?
Definition
Reduced or absent activity of the enzyme 21 hydroxylase.
Term
Name two drugs that can precipitate primary adrenal insufficiency
Definition
Ketaconazole (antifungal) and etomidate (anaesthetic)
Term
What is the pathogenesis of adrenoleukodystrophy?
Definition
Defective oxidation of fatty acids leads to a buildup of long chain FAs in the serum, CNS and adrenal cortex. Primary adrenal insufficiency as well as neurological dysfunction may result.
Term
In the neoplastic destruction of the pituitary, when does the loss of ACTH reserves tend to occur?
Definition
Late, compared to GnRH/GH/TSH
Term
What are the most common clinical manifestations of adrenal insufficiency?
Definition
Weakness
Hypotension
Anorexia/Nausea/Vomiting
Weight Loss
Term
What's the deal with hyperpigmentation in adrenal insufficiency?
Definition
Hyperpigmentation is caused by high ACTH levels. Therefore, it is a feature of primary adrenal insufficiency only.
Term
How is the definitive diagnosis of adrenal insufficiency made?
Definition
Short ACTH test.
Term
What is the only preparation available to for glucocorticoid replacement?
Definition
fludrocortisone
Term
How is catecholamine relsease from chromaffin cells stimulated?
Definition
Acetylcholine released from preganglionic sympathetic nerve endings
Term
What cells are 10% of pheochromocytomas derived from?
Definition

Sympathetic Ganglia (chromaffin cells).

 

The other 90% are adrenal chromaffin cell derived.

Term
What is the inheritance of familial pheochromocytome?
Definition
Autosomal Dominant
Term
What is the hallmark of pheochromocytoma?
Definition
Paroxysmal hypertension
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