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Flashcards in Adrenal condensed Deck (12)
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1
Q

Where are mineralocortiocoid receptors?

A

Kidneys, gut and glands (sweat and salivary)

2
Q
Dark skin
Dehydrated
Hypotensive
 Na K
Weight loss
Amenorrhea
A

Decreased Na+
Increased K+
(addisons)

3
Q

Causes of adrenal insufficiency (primary and secondary)

A
Primary insufficiency
Addison’s disease
Congenital Adrenal Hyperplasia (CAH)
Adrenal TB/malignancy
Secondary insufficiency	
Due to lack of ACTH stimulation
Iatrogenic (excess exogenous steroid)
Pituitary/hypothalamic disorders
4
Q

Autoimmune diseases associated with Addisons

A

Type 1 DM, autoimmune thyroid disease, pernicious anaemia

5
Q

Diagnosis of adrenal insufficiency

A
‘Suspicious biochemistry’
low Na, high K
hypoglycaemia
SHORT SYNACTHEN TEST
Measure plasma cortisol before and 30 minutes after iv ACTH injection
Normal: baseline >250nmol/L, post ACTH >480 
ACTH levels
Should be  (causes skin pigmentation)
Renin/aldosterone levels
 renin  aldosterone
Adrenal autoantibodies
6
Q

Prolactinoma symptoms

A

Infertility
Lack of libido
Amenorrhea

7
Q

Tumour derived from the remnants of Rathke’s pouch?

A

Craniopharyngioma

headache, visual disturbances, hypopituitarism

8
Q

What do neuroendocrine cells secrete?

A

Catecholamines

9
Q

Features suggesting adrenocortical carcinoma?

A
Large size (>50g, often >20cm)
Haemorrhage and necrosis
Frequent mitoses, atypical mitoses
Lack of clear cells
Capsular or vascular invasion
10
Q

In phaeochromoctyoma, what might cause a paroxysmal episode of hypertension?

A
  • Stress
  • Exercise
  • Posture
  • Palpation of tumour (e.g. feeling the tummy can cause release of adrenaline)
11
Q

Sipple syndrome

A

MEN2A

12
Q

Phaeochromocytoma (40-50%), Medullary thyroid carcinoma (100%), parathyroid hyperplasia (10-20%)
Phaeochromocytoma may be bilateral and occur at extra-adrenal sites
Linked to germline gain of function mutation in RET oncogene on chromosome 10q11.2 (ie constitutively activated)

A

MEN2A (Sipple syndrome)