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Cushing Syndrome is an increase in this hormone:
cortisol
why could cortisol be increased and causing Cushings?
1. exogenous corticosteroids, resulting in decreased ACHT and bilat adrenal atrophy
2. primary adrenal adenoma hyperplasia or carcinoma, decreased ACTH and atrophy of uninvolvedÂ
adrenal gland
3. ACTH secreting pituitary adenoma, leading to increased ACTH; most common
Name pathological signs/symptoms of Cushing syndrome
1. hypertension
2. weight gain
3. moon facies
4. abdominal striae
5. truncal obesity
6. buffalo hump
7. osteoporosis
8. hyperglycemia/insulin resis
9. amenorrhea
10. immunosuppression
How do you treat adrenal insufficiency?
glucocorticoid/mineralcorticoid replacement
Describe the differential diagnosis between primary adrenal insufficiency versus secondary/tertiaryÂ
adrenal insufficiency
primary: low cortisol, high ACTH
secondary/tertiary: low cortisol, low ACTH, due to pituitary disease, + response to ACTH stimulation test
What is the name of primary adrenal insufficiency?
chronic condition - Addisons Disease (JFK, increased MSH levels)
acute - occurs as a result of hemorrhage
Hyperaldosteronism features clinical presentation of the following symptoms:
hypertension
decreased or normal K+
metabolic alkalosis
there is no edema due to aldosterone escape mechanism
what is the aldosterone escape mechanism?
aldosterone escape:
starling forces favor back flow of Na+ and water into tubules, which is then urinated out following aÂ
transient increase in Na+ reabsorption
Primary hyperaldosteroneism is seen with _____syndrome and in ________________ _______________Â
hyperplasia
primary hyperaldosteronism is seen with *Conn syndrome and in bilateral adrenal* hyperplasia
Most common tumor of the adrenal medulla in children under 4 yrs old?
neuroblastoma, originating from neural crest cells; occurs anywhere along the sympathetic chain
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