Term
| What is the most common cause of isolated, non-medication related aldosterone deficiency? |
|
Definition
| Hyporeninemic hypoaldosteronism. It is related to diabetic nephropathy. |
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|
Term
| What is the major clinical concern in patients with aldosterone deficiency? |
|
Definition
Hyperkalemia.
Harmful effects include cardiac asystole. Kyperkalemia may be treated with furosemide or flucortisone. |
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Term
| Which hormone deficiency is responsible for the predominant clinical manifestations of adrenal insufficiency? |
|
Definition
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Term
| Which is more common, primary or secondary adrenal insufficiency, and why? |
|
Definition
| Secondary adrenal insuffiency is more common because of iatrogenic reasons. Glucocorticoids given as anti-inflammatory medication are the specific cause. |
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|
Term
| What is the most common cause of chronic adrenal insufficiency (Addison's Disease)? |
|
Definition
|
|
Term
| What are the genetics of APECED syndrome? |
|
Definition
| Autosomal recessive mutation of AIRE gene on chromosome 21 |
|
|
Term
| What is waterhouse-friderickson syndrome? |
|
Definition
| Adrenal hemorrhage in the context of bacterial sepsis. |
|
|
Term
| What are the top 2 risk factors for adrenal hemorrhage? |
|
Definition
1. Anticoagulation therapy
2. DIC associated with sepsis |
|
|
Term
| What is the leading cause of acute primary adrenal insufficiency? |
|
Definition
| Adrenal Apoplexy (bilateral massive spontaneous adrenal hemorrhage) |
|
|
Term
| What is the most common cause of congenital adrenal hyperplasia? |
|
Definition
| Reduced or absent activity of the enzyme 21 hydroxylase. |
|
|
Term
| Name two drugs that can precipitate primary adrenal insufficiency |
|
Definition
| Ketaconazole (antifungal) and etomidate (anaesthetic) |
|
|
Term
| What is the pathogenesis of adrenoleukodystrophy? |
|
Definition
| Defective oxidation of fatty acids leads to a buildup of long chain FAs in the serum, CNS and adrenal cortex. Primary adrenal insufficiency as well as neurological dysfunction may result. |
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|
Term
| In the neoplastic destruction of the pituitary, when does the loss of ACTH reserves tend to occur? |
|
Definition
| Late, compared to GnRH/GH/TSH |
|
|
Term
| What are the most common clinical manifestations of adrenal insufficiency? |
|
Definition
Weakness
Hypotension
Anorexia/Nausea/Vomiting
Weight Loss |
|
|
Term
| What's the deal with hyperpigmentation in adrenal insufficiency? |
|
Definition
| Hyperpigmentation is caused by high ACTH levels. Therefore, it is a feature of primary adrenal insufficiency only. |
|
|
Term
| How is the definitive diagnosis of adrenal insufficiency made? |
|
Definition
|
|
Term
| What is the only preparation available to for glucocorticoid replacement? |
|
Definition
|
|
Term
| How is catecholamine relsease from chromaffin cells stimulated? |
|
Definition
| Acetylcholine released from preganglionic sympathetic nerve endings |
|
|
Term
| What cells are 10% of pheochromocytomas derived from? |
|
Definition
Sympathetic Ganglia (chromaffin cells). The other 90% are adrenal chromaffin cell derived. |
|
|
Term
| What is the inheritance of familial pheochromocytome? |
|
Definition
|
|
Term
| What is the hallmark of pheochromocytoma? |
|
Definition
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