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11 Cards in this Set
- Front
- Back
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Adrenal cortex is derived from what (embryologically speaking)?
Medulla? Why does this make sense re: pheochromocytomas? |
mesoderm
neural ectoderm (neural crest cells) The neural crest cells also form the related sympathetic ganglia, so it makes sense that the ~10% of pheo's that don't appear in the adrenal medulla will appear in the sympathetic ganglia. |
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Name the layers of the adrenal gland from outer to inner, and list their associated products.
which layers respond to renin? ACTH? |
glomerulosa: aldo
fasciculata: cortisol/androgen reticularis: cortisol/androgen medulla: catecholamines renin = glomerulosa ACTH = fasciculata, reticularis |
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In the case of a functional adenoma of the adrenal gland, what happens to the other normal cells that are supposed to be secreting the same product as the tumor cells?
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they atrophy, assuming the negative feedback mechanisms are still functioning.
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What is the most common functional tumor of the adrenals?
Are most adrenal tumors in general functional? |
cortisol secretic tumor.
yes, 80% are. |
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What do chronic metastases from other sites (lung, breast, melanoma, etc) have to do in order to cause adrenal sx dz?
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destroy 90% of the adrenal tissue,
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In pts w/ autoimmune adrenalitis, what % have antibodies that also involve other endocrine glands?
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50%
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Worldwide, what is the major cause of primary chronic adrenal insufficiency?
- what is seen histologically? |
TB adrenalitis.
- granulomas (epitheloid macrophages that may or may not have formed multinucleate giant cells) |
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What types of etiology can cause hemorrhage in the adrenals?
- what is the pathogenesis? |
anticoag tx
DIC bacterial sepsis, as in Waterhouse-Fridrichsen Sx - bilateral adrenal hemorrhage --> actue hemorrhagic necrosis --> primary adrenal insuff. |
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What is Waterhouse-Friderichsen syndrome?
- prevalence? - etiology? |
septicemia --> hypotension, DIC --> massive adrenal hemorrhage, skin purpura --> death.
- pretty uncommon. Neisseria meningitidis >> pseudomonas |
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Primary hyperaldosteronism is also called what?
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Conn syndrome.
- caused by a adrenal adenoma in the glomerulosa. |
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Are most pheochromocytomas sporadic or famillial?
Main presenting sx? - surgically correctable? - gross? histo? |
90% sporadic
HTN - yes - circumscribed, solid, dark - nests of neoplastic cells. |
