Mhd Endorcine Pathology Adrenal

Front 1

Layers of the adrenal gland, superficial to deep, including the hormones made?

Back 1

Capsule, zona glomerulosa: aldosterone, zona fasciculata: glucocorticoids(cortisol), zona reticularis: sex steriods(estrogen and androgen), Medulla: catecholamines(epinephrine)

Front 2

Pathogenesis of Cushing syndrome?

Back 2

Pituitary of hyothalamic(Basophilic adenoma), Adrenal(tumor of hyperplasia), Paraneoplastic(small cell carcinoma of lung: ectopic ACTH), Iatrogenic(exogenous source: most common)

Front 3

Clinical manifestation of Cushing syndrome?

Back 3

Central obesity, Moon facies, weakness and fatigability, Hirsutism, acne, Hypertension, plethora, diabetes, osteoporosis, psychosis, purple stria, easy bruising, poor wound healing

Front 4

Test to determine type of Cushing Syndrome?

Back 4

Dexamethasone test.
Pituitary: resistant to low dose
Ectopic: Completely insensitive
Adrenal: Low ACTH

Front 5

Conn syndrome?

Back 5

Primary hyperaldosteronism, solitary adenoma of the cortex

Front 6

Clinical Manifestations of Primary hyperaldosteronism?

Back 6

Hypertension, sodium and water retention, hypokalemia, often with hypokalemic alkalosis, weakness, parasthesia, visual disterbances

Front 7

Renin level due to Primary hyperaldosteronism?

Back 7

Renin level decreases with due to negative feedback

Front 8

Causes of secondary hyperaldosronism serum renin?

Back 8

Renal ischemia, Renal tumor, edema. Serum renin is increased

Front 9

Pathogenesis of Adrenal virilism?

Back 9

Congenital enzyme defects (21/11-hydroxylase), lead to decrease cortisol, leads to increased ACTH, adrenal hyperplasia, increased androgenic steroid produced

Front 10

Congenital Adrenal Hyperplasia?

Back 10

AR, 90% of CAH, 21-hydroxylase deficiency (CYP21B), Salt wasting and andrigogenitalism

Front 11

Waterhouse-Freidrichsen Syndrome?

Back 11

Hemorrhagic necrosis of adrenals due to Meningococcal meningitis. Associated with Disseminated intravascular Coaggulation(DIC).
Results in catastrophic adrenal insufficiency

Front 12

Primary acute adrenocortical insufficiency?

Back 12

Can be caused by rapid withdrawal of steroids when adrenals have been supressed for long time

Front 13

Primary Chronic adrenocortical insufficiency?

Back 13

Addison's disease

Front 14

Etiologies of Addison's disease?

Back 14

Autoimmune adrenalitis(70%)
Infectios(tuberculosis of fungi)
Cancer Mets(lung, stomach and breast)

Front 15

Autoimmune adrenalitis?

Back 15

APS1: AIRE gene, candidiasis
APS2: Thyroiditis and DM type1
Isolated Autoimmine Addison's disease

Front 16

Layers of the adrenal gland, superficial to deep, including the hormones made?

Back 16

Capsule, zona glomerulosa: aldosterone, zona fasciculata: glucocorticoids(cortisol), zona reticularis: sex steriods(estrogen and androgen), Medulla: catecholamines(epinephrine)

Front 17

Pathogenesis of Cushing syndrome?

Back 17

Pituitary of hyothalamic(Basophilic adenoma), Adrenal(tumor of hyperplasia), Paraneoplastic(small cell carcinoma of lung: ectopic ACTH), Iatrogenic(exogenous source: most common)

Front 18

Clinical manifestation of Cushing syndrome?

Back 18

Central obesity, Moon facies, weakness and fatigability, Hirsutism, acne, Hypertension, plethora, diabetes, osteoporosis, psychosis, purple stria, easy bruising, poor wound healing

Front 19

Test to determine type of Cushing Syndrome?

Back 19

Dexamethasone test.
Pituitary: resistant to low dose
Ectopic: Completely insensitive
Adrenal: Low ACTH

Front 20

Conn syndrome?

Back 20

Primary hyperaldosteronism, solitary adenoma of the cortex

Front 21

Clinical Manifestations of Primary hyperaldosteronism?

Back 21

Hypertension, sodium and water retention, hypokalemia, often with hypokalemic alkalosis, weakness, parasthesia, visual disterbances

Front 22

Renin level due to Primary hyperaldosteronism?

Back 22

Renin level decreases with due to negative feedback

Front 23

Causes of secondary hyperaldosronism serum renin?

Back 23

Renal ischemia, Renal tumor, edema. Serum renin is increased

Front 24

Pathogenesis of Adrenal virilism?

Back 24

Congenital enzyme defects (21/11-hydroxylase), lead to decrease cortisol, leads to increased ACTH, adrenal hyperplasia, increased androgenic steroid produced

Front 25

Congenital Adrenal Hyperplasia?

Back 25

AR, 90% of CAH, 21-hydroxylase deficiency (CYP21B), Salt wasting and andrigogenitalism

Front 26

Waterhouse-Freidrichsen Syndrome?

Back 26

Hemorrhagic necrosis of adrenals due to Meningococcal meningitis. Associated with Disseminated intravascular Coaggulation(DIC).
Results in catastrophic adrenal insufficiency

Front 27

Primary acute adrenocortical insufficiency?

Back 27

Can be caused by rapid withdrawal of steroids when adrenals have been supressed for long time

Front 28

Primary Chronic adrenocortical insufficiency?

Back 28

Addison's disease

Front 29

Etiologies of Addison's disease?

Back 29

Autoimmune adrenalitis(70%)
Infectios(tuberculosis of fungi)
Cancer Mets(lung, stomach and breast)

Front 30

Layers of the adrenal gland, superficial to deep, including the hormones made?

Back 30

Capsule, zona glomerulosa: aldosterone, zona fasciculata: glucocorticoids(cortisol), zona reticularis: sex steriods(estrogen and androgen), Medulla: catecholamines(epinephrine)

Front 31

Autoimmune adrenalitis?

Back 31

APS1: AIRE gene, candidiasis
APS2: Thyroiditis and DM type1
Isolated Autoimmine Addison's disease

Front 32

Pathogenesis of Cushing syndrome?

Back 32

Pituitary of hyothalamic(Basophilic adenoma), Adrenal(tumor of hyperplasia), Paraneoplastic(small cell carcinoma of lung: ectopic ACTH), Iatrogenic(exogenous source: most common)

Front 33

Clinical manifestation of Cushing syndrome?

Back 33

Central obesity, Moon facies, weakness and fatigability, Hirsutism, acne, Hypertension, plethora, diabetes, osteoporosis, psychosis, purple stria, easy bruising, poor wound healing

Front 34

Test to determine type of Cushing Syndrome?

Back 34

Dexamethasone test.
Pituitary: resistant to low dose
Ectopic: Completely insensitive
Adrenal: Low ACTH

Front 35

Conn syndrome?

Back 35

Primary hyperaldosteronism, solitary adenoma of the cortex

Front 36

Clinical Manifestations of Primary hyperaldosteronism?

Back 36

Hypertension, sodium and water retention, hypokalemia, often with hypokalemic alkalosis, weakness, parasthesia, visual disterbances

Front 37

Renin level due to Primary hyperaldosteronism?

Back 37

Renin level decreases with due to negative feedback

Front 38

Causes of secondary hyperaldosronism serum renin?

Back 38

Renal ischemia, Renal tumor, edema. Serum renin is increased

Front 39

Pathogenesis of Adrenal virilism?

Back 39

Congenital enzyme defects (21/11-hydroxylase), lead to decrease cortisol, leads to increased ACTH, adrenal hyperplasia, increased androgenic steroid produced

Front 40

Congenital Adrenal Hyperplasia?

Back 40

AR, 90% of CAH, 21-hydroxylase deficiency (CYP21B), Salt wasting and andrigogenitalism

Front 41

Waterhouse-Freidrichsen Syndrome?

Back 41

Hemorrhagic necrosis of adrenals due to Meningococcal meningitis. Associated with Disseminated intravascular Coaggulation(DIC).
Results in catastrophic adrenal insufficiency

Front 42

Primary acute adrenocortical insufficiency?

Back 42

Can be caused by rapid withdrawal of steroids when adrenals have been supressed for long time

Front 43

Primary Chronic adrenocortical insufficiency?

Back 43

Addison's disease

Front 44

Etiologies of Addison's disease?

Back 44

Autoimmune adrenalitis(70%)
Infectios(tuberculosis of fungi)
Cancer Mets(lung, stomach and breast)

Front 45

Autoimmune adrenalitis?

Back 45

APS1: AIRE gene, candidiasis
APS2: Thyroiditis and DM type1
Isolated Autoimmine Addison's disease

Front 46

Clinical manifestation of Addison's Disease?

Back 46

Weakness and easy fatigability, GI:NVD, weightloss, Hyperpigmentation(increase ACTH/MSH), hyperkalemia, hyponatremia, volume depetion, hypotension, hypoglycemia

Front 47

Causes of Secondary Adrenocortical insufficiency?

Back 47

Pituitary and hypothalamus: mets, cancer, infarction, irradiation, no hyperpigmentation, no hyperkalemia/hyponatremia

Front 48

Chromaffin cells?

Back 48

From neural crest cells, synthesize and release catecholamines(EPI and NE) in response to preganglionic sypathetic nerve cells

Front 49

Pheochromocytoma's rules of 10?

Back 49

10% familial
10% Extrarenal(paragangliomas)
10% of nonfamilial are bilateral
10% arise in childhood(m>f)

Front 50

Benign of malignant Pheochromocytoma?

Back 50

Mets are the only way to tell

Front 51

Clinicall manifestation of Pheochromocytoma?

Back 51

Hypertension: sustained of paroxysmal, headache, sweating, anxiety, tremor, acute MI, CHF, V-fib, Stroke

Front 52

Diagnosis of Pheochromocytoma?

Back 52

Increased urine excretion of catecholamines and metabolites (Vanillylmandelic acid:VMA and metanephrines)

Front 53

When do you get a Neuroblastoma?

Back 53

Early Chidhood

Front 54

What is a Neuroblastoma?

Back 54

Malignant catecholamine-producing tumor found in adrenal medula or extra-adrenal paraganglionic tissue

Front 55

Clinical Manefistation of Neuroblastoma?

Back 55

90% before age 5, large abdominal mass in younger children, Hypertension, sometimes differentiat into benign cells and stop making N-myc gene

Front 56

Tumors in MEN-I?

Back 56

Parathyroid: hyperplasia, adenoma
Pituitary adenoma
Pancreas: Hyperplasia, adenoma, carcinoma
MEN-I Gene

Front 57

Tumors in MEN-IIa?

Back 57

Thyroid medullary carcinoma (c-cell)
Pheochromocytoma
Hyperparathyroid
RET gene

Front 58

Tumors in MEN-IIb?

Back 58

Thyroid Medullary Carcinoma
Pheochromocytoma
Ganglioneuromas
Marfanoid Habitus