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Questions and Answers
What is the main difference between primary adrenal insufficiency and secondary adrenal insufficiency?
What is the main difference between primary adrenal insufficiency and secondary adrenal insufficiency?
- Primary adrenal insufficiency is due to a problem in the hypothalamus, whereas secondary adrenal insufficiency is due to a problem in the adrenal gland.
- Primary adrenal insufficiency is more severe than secondary adrenal insufficiency.
- Primary adrenal insufficiency is more common than secondary adrenal insufficiency.
- Primary adrenal insufficiency is due to a problem in the adrenal gland, whereas secondary adrenal insufficiency is due to a problem elsewhere in the body. (correct)
What is Waterhouse-Friderichsen syndrome?
What is Waterhouse-Friderichsen syndrome?
- A type of acute adrenal insufficiency (correct)
- A type of hyperaldosteronism
- A type of Cushing syndrome
- A type of chronic adrenal insufficiency
What is the term for a tumor of the adrenal cortex?
What is the term for a tumor of the adrenal cortex?
- Pheochromocytoma
- Neuroblastic tumor
- Adrenocortical adenoma (correct)
- Adrenocortical carcinoma
What is Conn syndrome?
What is Conn syndrome?
What is the term for destruction of the adrenal gland due to various causes?
What is the term for destruction of the adrenal gland due to various causes?
What type of cells can give rise to pheochromocytoma?
What type of cells can give rise to pheochromocytoma?
What is the primary cause of hyperpigmentation in Addison disease?
What is the primary cause of hyperpigmentation in Addison disease?
What is the primary symptom of Addisonian crisis?
What is the primary symptom of Addisonian crisis?
What is the purpose of ACTH stimulation test in diagnosing Addison disease?
What is the purpose of ACTH stimulation test in diagnosing Addison disease?
What is the primary treatment for hypovolemia and hypotension in Addison disease?
What is the primary treatment for hypovolemia and hypotension in Addison disease?
What is the primary cause of adrenal crisis in Addison disease?
What is the primary cause of adrenal crisis in Addison disease?
What is the primary role of fludrocortisone in the treatment of Addison disease?
What is the primary role of fludrocortisone in the treatment of Addison disease?
What is the most common cause of Addison disease in high-income countries?
What is the most common cause of Addison disease in high-income countries?
Which adrenal gland layer is responsible for aldosterone production?
Which adrenal gland layer is responsible for aldosterone production?
What is the result of aldosterone levels dropping in Addison disease?
What is the result of aldosterone levels dropping in Addison disease?
Which of the following is NOT a clinical manifestation of Addison disease?
Which of the following is NOT a clinical manifestation of Addison disease?
What is the primary cause of Addison disease in other countries?
What is the primary cause of Addison disease in other countries?
What is the genetic cause of Sturge-Weber Syndrome?
What is the genetic cause of Sturge-Weber Syndrome?
What is a common symptom of pheochromocytoma?
What is a common symptom of pheochromocytoma?
What is the consequence of untreated hypertension caused by pheochromocytoma?
What is the consequence of untreated hypertension caused by pheochromocytoma?
What is the term for the increased pressure in the blood vessels due to pheochromocytoma?
What is the term for the increased pressure in the blood vessels due to pheochromocytoma?
What is the name of the tumor that causes pheochromocytoma?
What is the name of the tumor that causes pheochromocytoma?
What is the primary function of CXCL12 in neuroblastoma?
What is the primary function of CXCL12 in neuroblastoma?
Which symptom of neuroblastoma is dependent on the location of the metastatic tumor?
Which symptom of neuroblastoma is dependent on the location of the metastatic tumor?
What is the primary diagnostic test used to measure the size and location of a neuroblastoma tumor?
What is the primary diagnostic test used to measure the size and location of a neuroblastoma tumor?
What is the typical treatment for neuroblastoma with metastasis?
What is the typical treatment for neuroblastoma with metastasis?
Which of the following is a symptom of neuroblastoma in the bone marrow?
Which of the following is a symptom of neuroblastoma in the bone marrow?
What is the primary diagnostic marker used to detect neuroblastoma?
What is the primary diagnostic marker used to detect neuroblastoma?
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Study Notes
Adrenal Gland Dysfunction
- Primary adrenal insufficiency occurs when the adrenal gland cannot produce enough hormones, particularly aldosterone and cortisol, due to damage to the adrenal cortex.
Primary Adrenal Insufficiency
- Can be either acute or chronic
- Acute: Waterhouse-Friderichsen syndrome
- Chronic: Addison disease
Addison Disease
- Caused by progressive destruction of the adrenal gland from various causes
- Symptoms dependent on the adrenal gland layer(s) destroyed
- Zona fasciculata destruction: cortisol levels drop, leading to hypoglycemia, and hyperpigmentation
- Zona glomerulosa destruction: aldosterone levels drop, leading to hyperkalemia, hyponatremia, hypovolemia, hypotension, and metabolic acidosis
Addison Disease: Clinical Manifestations
- Symptoms worsen with stressors such as injury, surgery, or infection, leading to Addisonian crisis
Diagnosis of Addison Disease
- Cortisol measurements
- ACTH measurements
- ACTH stimulation test
- Aldosterone and renin levels
- Adrenal CT/MRI
- 21-hydroxylase antibodies
Treatment of Addison Disease
- Hormone replacement therapy:
- Low cortisol: corticosteroids
- Low aldosterone: fludrocortisone
- Hypovolemia/hypotension: IV fluids and vasopressors
- Hypoglycemia: IV dextrose
Hyperaldosteronism
- Primary: Conn syndrome
- Treatment: hormone replacement therapy with fludrocortisone
Pheochromocytoma
- Classic signs and symptoms: secondary hypertension, headache, palpitations, diaphoresis, and stroke
- Metastasis: lymph nodes, liver, bones, and bone marrow
Neuroblastoma
- Symptoms: fever, weight loss, sweating, and fatigue
- Other symptoms dependent on location of metastatic tumor
- Diagnosis: urinary and serum homovanillic acid (HMA) and vanillylmandelic acid (VMA) measurements, CT scan, and complete blood count
- Treatment: depends on size and stage of neuroblastoma, may include chemotherapy, medication, and bone marrow transplantation
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