Adrenal Pathologies BMS 200
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Questions and Answers

Which condition is primarily characterized by excessive cortisol production resulting from a pituitary adenoma?

  • Conn's disease
  • Addison's disease
  • Cushing's disease (correct)
  • Pheochromocytoma

    • What characterizes primary adrenal insufficiency compared to secondary adrenal insufficiency?

  • It leads to an increase in ACTH levels.
  • It is primarily caused by a pituitary tumor.
  • It originates from dysfunction at the level of the adrenal glands. (correct)
  • It typically presents with elevated aldosterone levels.

    • Which clinical feature is associated with Conn's disease?

  • Hypotension
  • Hypoglycemia
  • Hyperkalemia
  • Hypertension (correct)

    • Which diagnostic test would be most informative for confirming the presence of congenital adrenal hyperplasia?

    <p>17-OH progesterone testing</p> Signup and view all the answers

    What is a common complication associated with pheochromocytoma?

    <p>Severe hypertension</p> Signup and view all the answers

    Which of the following is NOT a source of excess cortisol associated with Cushing Syndrome?

    <p>Hypoaldosteronism</p> Signup and view all the answers

    What is the most common source of endogenous hypercortisolism?

    <p>Pituitary ACTH-producing microadenoma</p> Signup and view all the answers

    Which pathological condition is characterized by decreased levels of glucocorticoids?

    <p>Adrenocortical insufficiency</p> Signup and view all the answers

    Which condition may cause a significant hypersecretion of ACTH leading to Cushing Syndrome?

    <p>Ectopic ACTH secretion from small cell lung cancer</p> Signup and view all the answers

    In the majority of cases of endogenous Cushing syndrome, what is typically noted in the pituitary gland?

    <p>Presence of an ACTH-producing microadenoma</p> Signup and view all the answers

    What percentage of Cushing syndrome cases are attributed to ectopic ACTH production?

    <p>5 to 10%</p> Signup and view all the answers

    In which demographic is Cushing Disease more prevalent?

    <p>Women in their twenties and thirties</p> Signup and view all the answers

    What is the consequence of an adrenal adenoma found in one adrenal gland in the case of Cushing syndrome?

    <p>Atrophy of the unaffected adrenal gland</p> Signup and view all the answers

    What characterizes primary hyperaldosteronism?

    <p>Excess aldosterone secretion</p> Signup and view all the answers

    Which condition is associated with secondary hyperaldosteronism?

    <p>Decreased renal perfusion</p> Signup and view all the answers

    What is the expected result of an ACTH stimulation test in primary adrenal insufficiency?

    <p>No change in cortisol levels</p> Signup and view all the answers

    What is a common enzyme deficiency in Congenital Adrenal Hyperplasia (CAH)?

    <p>21-Hydroxylase</p> Signup and view all the answers

    What would represent a typical finding in a patient with primary hyperaldosteronism?

    <p>High serum aldosterone levels</p> Signup and view all the answers

    Which of the following conditions can lead to secondary hyperaldosteronism?

    <p>Cirrhosis</p> Signup and view all the answers

    What is the role of ACTH in adrenal function testing?

    <p>Stimulates cortisol production</p> Signup and view all the answers

    What effect does hyperaldosteronism typically have on potassium levels?

    <p>Decreased potassium levels</p> Signup and view all the answers

    What characterizes the salt-wasting form of classic Congenital Adrenal Hyperplasia (CAH)?

    <p>Complete inactivation of 21-hydroxylase</p> Signup and view all the answers

    In females with classic CAH, which condition is commonly observed at birth?

    <p>Ambiguous genitalia</p> Signup and view all the answers

    Which statement best describes the late-onset form of CAH?

    <p>It is often misdiagnosed as polycystic ovary syndrome in women.</p> Signup and view all the answers

    Which of the following is a characteristic clinical feature of pheochromocytoma?

    <p>Persistent hypertension</p> Signup and view all the answers

    What laboratory result is likely in individuals suspected of having late-onset CAH?

    <p>Increased 17 hydroxyprogesterone (17-OHP) levels</p> Signup and view all the answers

    What potential complication can arise from the paroxysmal hypertension associated with pheochromocytoma?

    <p>Hypertrophy of the heart</p> Signup and view all the answers

    What is the most common etiology of pheochromocytoma?

    <p>Sporadic occurrence</p> Signup and view all the answers

    Which treatment is considered curative for the hypertension associated with pheochromocytoma?

    <p>Surgical excision of the tumor</p> Signup and view all the answers

    What is the most common cause of adrenal insufficiency globally?

    <p>Tuberculosis</p> Signup and view all the answers

    Which statement about Addison's disease is true?

    <p>It can cause sudden adrenal crisis due to stress.</p> Signup and view all the answers

    Which feature is typically absent in secondary adrenocortical insufficiency compared to primary adrenal insufficiency?

    <p>Hyperpigmentation</p> Signup and view all the answers

    What condition can precipitate primary acute adrenocortical insufficiency?

    <p>Surgical recovery without medication adjustments</p> Signup and view all the answers

    Which of the following is a potential cause of adrenal hemorrhage?

    <p>Anticoagulant therapy</p> Signup and view all the answers

    What is the effect of the insulin tolerance test in diagnosing secondary adrenal insufficiency?

    <p>Cortisol and ACTH secretion should increase.</p> Signup and view all the answers

    In which scenario is acute adrenal insufficiency most likely to occur?

    <p>High stress without increased steroid doses</p> Signup and view all the answers

    What is a common clinical presentation of primary chronic adrenal insufficiency?

    <p>Hypotension</p> Signup and view all the answers

    What does an elevated level of ACTH indicate in a patient with suspected Cushing's syndrome?

    <p>Ectopic ACTH syndrome</p> Signup and view all the answers

    Which of the following diseases is categorized as an autoimmune cause of Addison's disease?

    <p>Autoimmune polyendocrine syndrome type 1</p> Signup and view all the answers

    Which condition could be a result of adrenal insufficiency during times of stress?

    <p>Adrenal crisis</p> Signup and view all the answers

    What is a common sign in patients suffering from Addison's disease?

    <p>Hypoglycemia</p> Signup and view all the answers

    What physiological effect does the withdrawal of glucocorticoids too rapidly cause?

    <p>Adrenal crisis due to inability to produce glucocorticoids</p> Signup and view all the answers

    Study Notes

    Adrenal Pathologies Overview

    • Adrenal disorders can manifest as hyperfunction (excess hormone production) or hypofunction (insufficient hormone production).
    • Hyperfunction includes conditions such as Cushing's syndrome, hyperaldosteronism, and pheochromocytoma.
    • Hypofunction primarily involves adrenal insufficiency and congenital adrenal hyperplasia.

    Cushing's Syndrome and Disease

    • Cushing's syndrome results from elevated glucocorticoid levels, often due to factors such as iatrogenic causes, hypothalamic-pituitary diseases, adrenal adenomas, or ectopic ACTH production.
    • Hypersecretion of ACTH accounts for 70-80% of Cushing's syndrome cases, predominantly affecting women in their twenties and thirties.
    • Cushing's Disease specifically refers to pituitary adenoma producing ACTH; adrenal glands may exhibit changes due to cortisol overproduction.
    • Ectopic ACTH production, typically from tumors like small cell lung cancer, accounts for about 10% of cases.
    • Adrenocortical carcinoma is a rare cause of primary Cushing's syndrome and often presents with severe symptoms.

    Adrenal Insufficiency

    • Adrenal insufficiency can be classified as primary (Addison's disease) or secondary (decreased ACTH stimulation).
    • Acute adrenal insufficiency may arise from rapid glucocorticoid withdrawal, adrenal hemorrhage, or stress in chronic insufficiency cases.
    • Addison's disease results from 90% destruction of the adrenal cortex, often due to autoimmune processes, tuberculosis, or malignancy.

    Clinical Features of Addison’s Disease

    • Initial symptoms include fatigue, gastrointestinal disturbances, and hyperpigmentation.
    • Patients may experience hypotension, hypokalemia, and can develop acute crises during stress without adequate corticosteroid therapy.
    • If untreated, adrenal crises can be fatal.

    Secondary Adrenocortical Insufficiency

    • Caused by hypothalamic or pituitary disorders leading to reduced ACTH output; characterized by deficient cortisol with normal aldosterone levels.
    • Patients do not exhibit hyperpigmentation typical of primary insufficiency.

    Hyperaldosteronism

    • Primary hyperaldosteronism (Conn's syndrome) involves autonomous aldosterone overproduction, leading to hypertension and hypokalemia.
    • Secondary hyperaldosteronism results from increased renin levels due to conditions like renal perfusion issues or heart failure.

    Primary Hyperaldosteronism Clinical Features

    • Hypertension results from sodium retention, while hypokalemia causes neuromuscular symptoms.
    • Diagnosis can involve measuring serum aldosterone and renin levels for aldosterone: renin ratio.

    Congenital Adrenal Hyperplasia (CAH)

    • CAH is an autosomal recessive disorder, often due to a deficiency in 21-hydroxylase, leading to cortisol production deficits.
    • Classic forms include salt-wasting conditions that can be fatal without treatment, and simple virilizing forms that cause ambiguous genitalia in females at birth.
    • Non-classic CAH presents later in life, often mimicking polycystic ovary syndrome in females.

    Pheochromocytoma

    • Pheochromocytoma arises from chromaffin cells in the adrenal medulla, producing excess catecholamines.
    • Clinical features prominently include hypertension, which can be paroxysmal; episodes may lead to serious cardiovascular complications.
    • Surgical resection can effectively treat the resulting hypertension.
    • Insulin tolerance tests, CRH tests, and ACTH stimulation tests help differentiate between adrenal insufficiency types and assess adrenal response.
    • Specific hormones measured include cortisol, ACTH, aldosterone, and 17-hydroxyprogesterone, contributing to diagnosis and treatment plans.

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    Adrenal Pathology Week 3 PDF

    Description

    This quiz covers key concepts in adrenal pathologies, including Cushing's syndrome, Addison's disease, and Conn's disease. Additionally, it examines pheochromocytoma and its pathological findings. Test your understanding of their pathophysiology and clinical features relevant to BMS 200.

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