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Questions and Answers
What is the primary dysfunction location in Cushing's disease?
What is the primary dysfunction location in Cushing's disease?
Which of the following clinical features is most commonly associated with Addison's disease?
Which of the following clinical features is most commonly associated with Addison's disease?
Which diagnostic test is most relevant for diagnosing Conn's disease?
Which diagnostic test is most relevant for diagnosing Conn's disease?
What is a common complication associated with pheochromocytoma?
What is a common complication associated with pheochromocytoma?
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In adrenal neoplasms, which feature is typically correlated with poor prognosis?
In adrenal neoplasms, which feature is typically correlated with poor prognosis?
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What is the primary consequence of complete inactivation of 21-hydroxylase in salt-wasting congenital adrenal hyperplasia?
What is the primary consequence of complete inactivation of 21-hydroxylase in salt-wasting congenital adrenal hyperplasia?
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What condition can late-onset non-classic congenital adrenal hyperplasia in women mimic?
What condition can late-onset non-classic congenital adrenal hyperplasia in women mimic?
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What is a common characteristic of female infants with simple virilizing congenital adrenal hyperplasia?
What is a common characteristic of female infants with simple virilizing congenital adrenal hyperplasia?
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In patients diagnosed with pheochromocytoma, what is the typical secretion observed?
In patients diagnosed with pheochromocytoma, what is the typical secretion observed?
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What lab finding is expected in a patient with non-classic congenital adrenal hyperplasia?
What lab finding is expected in a patient with non-classic congenital adrenal hyperplasia?
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What result indicates primary adrenal insufficiency during an ACTH stimulation test?
What result indicates primary adrenal insufficiency during an ACTH stimulation test?
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What is a characteristic feature of primary hyperaldosteronism?
What is a characteristic feature of primary hyperaldosteronism?
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Which condition is a possible cause of secondary hyperaldosteronism?
Which condition is a possible cause of secondary hyperaldosteronism?
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How is congenital adrenal hyperplasia (CAH) primarily inherited?
How is congenital adrenal hyperplasia (CAH) primarily inherited?
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In primary hyperaldosteronism, what would you expect the aldosterone to renin ratio (ARR) to be?
In primary hyperaldosteronism, what would you expect the aldosterone to renin ratio (ARR) to be?
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What is the most common enzyme deficiency in congenital adrenal hyperplasia?
What is the most common enzyme deficiency in congenital adrenal hyperplasia?
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What is a key clinical manifestation of hypokalemia associated with hyperaldosteronism?
What is a key clinical manifestation of hypokalemia associated with hyperaldosteronism?
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Which factor is NOT associated with primary hyperaldosteronism?
Which factor is NOT associated with primary hyperaldosteronism?
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What is the expected appearance of adrenal tissue when an adenoma is found in only one adrenal gland?
What is the expected appearance of adrenal tissue when an adenoma is found in only one adrenal gland?
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Which scenario describes the mechanism of Cushing's disease?
Which scenario describes the mechanism of Cushing's disease?
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How can serum ACTH levels help differentiate between primary Cushing's disease and ACTH-dependent forms?
How can serum ACTH levels help differentiate between primary Cushing's disease and ACTH-dependent forms?
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What characterizes adrenal insufficiency as acute or chronic?
What characterizes adrenal insufficiency as acute or chronic?
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Why might sudden withdrawal from high doses of glucocorticoids lead to adrenal insufficiency?
Why might sudden withdrawal from high doses of glucocorticoids lead to adrenal insufficiency?
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What is a distinguishing factor between primary and secondary adrenal insufficiency?
What is a distinguishing factor between primary and secondary adrenal insufficiency?
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What role does cortisol play in feedback mechanisms within the endocrine system?
What role does cortisol play in feedback mechanisms within the endocrine system?
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In Cushing's syndrome, what does a high-dose dexamethasone suppression test typically show?
In Cushing's syndrome, what does a high-dose dexamethasone suppression test typically show?
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What is the primary cause of primary acute adrenocortical insufficiency?
What is the primary cause of primary acute adrenocortical insufficiency?
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Which of the following is NOT a clinical feature of acute adrenal insufficiency?
Which of the following is NOT a clinical feature of acute adrenal insufficiency?
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What is the most common cause of Addison's disease in developed countries?
What is the most common cause of Addison's disease in developed countries?
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Which of the following conditions is associated with secondary adrenocortical insufficiency?
Which of the following conditions is associated with secondary adrenocortical insufficiency?
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Which laboratory test would help determine if there is an ACTH deficiency?
Which laboratory test would help determine if there is an ACTH deficiency?
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What is a common consequence of stress on individuals with chronic adrenal insufficiency?
What is a common consequence of stress on individuals with chronic adrenal insufficiency?
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Which symptom is associated with chronic primary adrenal insufficiency in Addison's disease?
Which symptom is associated with chronic primary adrenal insufficiency in Addison's disease?
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What happens to sodium and potassium levels in Addison's disease?
What happens to sodium and potassium levels in Addison's disease?
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Which statement about acute adrenal hemorrhage is true?
Which statement about acute adrenal hemorrhage is true?
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Which type of autoimmune syndrome primarily affects older children and adolescents in Addison's disease pathogenesis?
Which type of autoimmune syndrome primarily affects older children and adolescents in Addison's disease pathogenesis?
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Study Notes
Adrenal Pathologies Overview
- Cushing's syndrome characterized by excess cortisol; Cushing's disease is specifically due to a pituitary tumor causing excess ACTH.
- Addison's disease indicates a deficiency in adrenal hormones, often due to autoimmune destruction of the adrenal cortex.
- Conn's disease results from hyperaldosteronism, leading to hypertension and hypokalemia due to excessive aldosterone production.
Cushing's Syndrome and Disease
- Cushing's syndrome presents with high cortisol, elevated ACTH in pituitary tumors, and low cortisol after dexamethasone suppression.
- Dexamethasone suppression test differentiates between various forms of Cushing’s.
- Ectopic ACTH production (from tumors like lung cancer) leads to high ACTH and cortisol levels; pituitary tumors show high ACTH coupled with high cortisol.
Addison's Disease and Adrenal Insufficiency
- Chronic adrenal insufficiency results from significant destruction of the adrenal cortex (90% affected).
- Common etiologies include autoimmune destruction, tuberculosis, AIDS, and metastatic cancer.
- Clinical features include progressive weakness, gastrointestinal symptoms, hyperpigmentation, hypotension, and acute adrenal crisis risk during stress.
Secondary Adrenal Insufficiency
- Typically results from hypothalamic or pituitary disorders leading to decreased ACTH levels.
- Presents with low cortisol and ACTH but normal aldosterone levels, avoiding complications like hyperkalemia.
- Insulin tolerance and CRH tests assess pituitary function and cortisol responsiveness.
Primary Hyperaldosteronism
- Characterized by excess aldosterone leading to sodium retention, potassium excretion, hypertension, and hypokalemia.
- Etiologies include adrenal neoplasms (Conn's syndrome) and bilateral adrenal hyperplasia.
- Aldosterone: renin ratios help distinguish between primary and secondary causes of hyperaldosteronism.
Congenital Adrenal Hyperplasia (CAH)
- Autosomal recessive disorder primarily due to 21-hydroxylase deficiency; leads to reduced cortisol and resulting adrenal hyperplasia.
- Classic forms include salt-wasting (complete 21-hydroxylase inactivation) and simple virilizing forms (partial function).
- Non-classic CAH manifests later in life, often resembling polycystic ovary syndrome in women.
Pheochromocytoma
- Rare tumor of adrenal chromaffin cells, predominantly secretes catecholamines (epinephrine/norepinephrine).
- Most cases are sporadic, but some arise in hereditary contexts, causing persistent hypertension and episodic symptoms like headaches and palpitations.
Diagnostic Tests
- Key tests include insulin tolerance, CRH stimulation, ACTH levels, cortisol testing, DXM suppression, and aldosterone:renin ratio.
- High 17-OH progesterone levels indicate CAH; elevated plasma renin suggests secondary hyperaldosteronism.
Complications
- Addisonian crisis can lead to severe hemodynamic instability, hypoglycemia, and potentially fatal outcomes without immediate treatment.
- Chronic adrenal insufficiency may remain asymptomatic until an acute stressor demands increased adrenal function.
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Description
Test your knowledge on adrenal disorders with this quiz that explores Cushing's disease, Addison's disease, Conn's disease, and pheochromocytoma. Evaluate your understanding of the clinical features, diagnostic tests, and prognostic factors associated with these conditions. Perfect for students and professionals in the field of endocrinology.
