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27 Cards in this Set
- Front
- Back
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What is the pathology of primary hyperaldosteronism?
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Adrenal hyperplasia or an aldosterone-secreting adrenal adenoma
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What are the symptoms of hyperaldosteronism?
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HTN, Hypokalemia, metabolic alkalosis, low plasma renin
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How do you treat primary hyperaldosteronism?
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Surgery for the tumor, spironolactone as an aldosterone antagonist
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What is the pathology of secondary hyperaldosteronism?
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Renal perception of low intravascular volume results in overactive renin-angiotensin system
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What is secondary hyperaldosteronism due to?
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Renal A stenosis, chronic renal failure, cirrhosis, nephrotic syndrome
HIGH plasma renin |
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How do you treat secondary hyperaldosteronism?
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Spironolactone
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What is the pathology of Addison's Disease?
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Chronic primary adrenal insufficiency from adrenal atrophy or destruction by disease
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What are the symptoms of Addison's?
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Deficiency of aldosterone and cortisol, causes hyperpigmentation
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What are the 3 A's of Addison's?
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Adrenal Atrophy
Absence of hormone production |
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What parts of the adrenal glands are affected by Addison's?
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All 3 cortical divisions, spares medulla
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What is the difference between Addison's and secondary adrenal insufficiency?
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Secondary = no skin hyperpigmentation and hyperkalemia
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What is the cause of tertiary adrenal insufficiency?
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Most common cause is abrupt withdrawal of long term corticosteroids
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What is the pathology of Waterhouse-Friderichsen Syndrome?
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Acute primary adrenal insufficiency from adrenal hemorrhage
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What pathogen is WF associated with?
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Neisserian Meningitidis
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What is the most common tumor of the adrenal medulla in adults?
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Pheochromocytoma
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Where does Pheochromocytoma arise from?
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Chromaffin cells (neural crest)
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What is the rule of 10's of pheochromocytoma?
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10% malignant
10% bilateral 10% extra-renal 10% calcify 10% kids |
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What do most tumors secrete and what does this cause?
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Secretes Epi, NE, dopamine, which can cause episodic HTN
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What is pheochromocytoma associated with?
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NF1
MEN 2A and 2B |
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What are the 5 P's of Pheochromocytoma?
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Pressure elevation
Pain (HA) Perspiration Palpitations (tachy) Pallor |
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What 3 lab vales are elevated in serum and urine in pheochromocytoma?
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HVA, Normetanephrine VMA and Metanephrine
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How do you treat Pheochromocytoma?
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Tumor surgically removed only after effective a and b blockade is achieved
Irreversible a-antagnosis (phenoxybenzamine) must be given first to avoid HTN crisis B-blockers are then given to slow the HR |
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What is the most common tumor of adrenal medulla in kids?
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Neuroblastoma
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Where does neuroblastoma occur?
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Sympathetic chain
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What lab value is elevated in neuroblastoma?
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HVA
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What is less likely to happen in neuroblastoma than other adrenal diseases?
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HTN
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What gene is overexpressed in Neuroblastoma that causes rapid tumor progression?
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N-myc oncogene
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