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Endocrinology | Medicine (MD/DO) School Study Aid


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Adrenal Disorders
16 Picmonics to Learn | 40 mins

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Hyperaldosteronism Overview
Mechanism
Adrenal Glands
Increased Aldosterone
Aldosterone Escape Mechanism
Clinical Findings
No Significant Edema
Hypertension
Hypokalemic Metabolic Alkalosis
Types
Primary Hyperaldosteronism
Secondary Hyperaldosteronism
Pseudohyperaldosteronism
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3 mins
Adrenoleukodystrophy
Pathophysiology
X-linked Recessive
Peroxisome Dysfunction
ABCD1 Mutation
Presentation
Adrenal Insufficiency
Leukoencephalopathy
Testicular Insufficiency
Diagnosis
Increased Very Long-chain Fatty Acids (VLCFA)
Demyelination
Genetic Testing
Treatment
Lorenzo's Oil
Hematopoietic Stem Cell Transplantation
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3 mins
Secondary Hyperaldosteronism
Etiologies
Renal Artery Stenosis
Reninoma
Chronic Disease of Liver, Kidney, or Heart
Clinical Features
Edema
Hypertension
Hypokalemic Metabolic Alkalosis
Diagnosis
Increased Aldosterone
Increased Renin
Treatment
Treat Underlying Disorder
Aldosterone Antagonists
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3 mins
Primary Hyperaldosteronism
Etiology
Increased Aldosterone Secretion
Adrenal Adenoma
Bilateral Adrenal Hyperplasia
Clinical Features
Hypertension
Hypokalemic Metabolic Alkalosis
No Significant Edema
Diagnosis
Increased Aldosterone
Decreased Renin
Abdominal CT Scan
Management
Aldosterone Antagonists
Surgery
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3 mins
11 Beta-Hydroxylase Deficiency
Pathophysiology
Decreased Cortisol
Decreased Aldosterone
Increased Sex Hormones
Increased 11 Deoxycorticosterone (11 DOC)
Signs and Symptoms
Hypertension
Masculinization
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1 min
17 Alpha Hydroxylase Deficiency
Decreased Cortisol
Decreased Sex Hormones
Increased Mineralocorticoids (DOC)
Hypertension
Hypokalemia
XY Externally Phenotypic Female
No Internal Reproductive Structures Due to Mullerian Inhibitory Factor
XX Externally Phenotypic Female
Sexual Infantilism
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2 mins
21 Hydroxylase Deficiency
Pathophysiology
Decreased Cortisol
Increased 17 Hydroxyprogesterone
Decreased Aldosterone
Signs and Symptoms
Hypotension
Increased Renin
Hyperkalemia
Female Pseudohermaphroditism
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2 mins
Pheochromocytoma
Cause/Mechanism
Adrenal Medulla Tumor
Increased Catecholamines
Assessment
Episodic Hypertension
Diaphoresis
Abdominal or Chest Pain
Interventions
Surgery
Antihypertensives
Phenoxybenzamine
Metyrosine (Demser)
Considerations
Do Not Palpate Abdomen
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3 mins
Waterhouse-Friderichsen Syndrome
Acute 1° Adrenal Insufficiency
Adrenal Hemorrhage
Hypotension
Neisseria meningitidis
DIC
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1 min
Addison's Disease
Mechanism
Chronic 1° Adrenal Insufficiency
Atrophy
Destruction
Symptoms
Deficiency In Cortisol And Aldosterone
Skin Hyperpigmentation
Increased POMC
Hypotension
Hyperkalemia
Acidosis
Addisonian Crisis
Diagnosis
ACTH (Cosyntropin) Stimulation Test
Treatment
Exogenous Cortisol
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2 mins
Addisonian Crisis
Assessment
Severe Symptoms
Shock
Interventions
High-Dose Hydrocortisone
Large Volumes of IV Fluid
Insulin with Dextrose
Kayexalate
Loop or Thiazide Diuretics
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2 mins
Cushing's Syndrome Characteristics
More Common in Women
Exogenous Etiologies
Glucocorticoids
Endogenous Etiologies
Decreased ACTH
Primary Adrenal Disease
Increased ACTH
Pituitary Adenoma (Cushing's Disease)
Paraneoplastic: Small Cell Carcinoma
CRF-releasing Tumors
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2 mins
Cushing's Syndrome Symptoms And Diagnosis
Symptoms/Findings
Osteoporosis
Amenorrhea
Truncal Obesity
Skin Changes
Buffalo Hump
Immune Suppression
Moon Facies
Hypertension
Decreased Insulin Sensitivity
Diagnosis
24-hour urine free Cortisol
Dexamethasone Suppression Test
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2 mins
Syndrome Of Apparent Mineralocorticoid Excess (SAME)
Pathophysiology
11 Beta-Hydroxysteroid Dehydrogenase Deficiency
Elevated Cortisol
Low Renin
Low Aldosterone 
Causes
Autosomal-Recessive
Licorice (glycyrrhetinic acid) Ingestion
Signs & Symptoms
Hypertension
Hypokalemia
Metabolic Alkalosis
Treatment
Potassium-Sparing Diuretics
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4 mins
Neuroblastoma Characteristics and Presentation
Characteristics
Malignant Neuroendocrine Tumor
Neural Crest Cells Origin
Sympathetic Ganglia
Adrenal Glands
Amplification of N-myc Oncogene
Most Common Cancer In Infancy
Clinical Presentation
Abdominal Mass That Can Cross Midline
Gastrointestinal Distress
Metastasis
Raccoon Eyes
Opsoclonus-Myoclonus Syndrome
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4 mins
Neuroblastoma Diagnosis and Management
Diagnosis
24-hour Urine Test
Increased Catecholamines
Homovanillic and Vanillylmandelic Acid
Ultrasound
Magnetic Resonance Imaging (MRI)
Biopsy
Pathology
Small Round Blue Cells
Homer-Wright Rosettes
Bombesin Positive
Neuron Specific Enolase Positive
Interventions
Local Excision
Chemotherapy
Radiation
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4 mins

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