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 uninvolved 

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/tertiary 

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 a 

transient increase in Na+ reabsorption

Primary hyperaldosteroneism is seen with _____syndrome and in ________________ _______________ 

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