MNE Clinical Correlates Exam Bank Solution Manual Already Passed

MNE Clinical Correlates Exam Bank Solution Manual Already Passed Addison's Disease - Answers Inability of the adrenal to produce sufficient glucocorticoids. Intolerance to stress, extreme sensitivity to insulin. Overproduction of ACTH and other POMC peptides results in increased pigmentation. Secondary adrenal insufficiency - Answers Lack of ACTH. Intolerance to stress, extreme sensitivity to insulin. Symptoms the same as Addison's disease except no increased pigmentation. Cushing's Disease - Answers Occurs with the growth of an ACTH secreting pituitary tumor. Increase in cortisol. Glucocorticoid excess. Due to overproduction of ACTH by a pituitary or ectopic tumor; adrenal tumor; pharmacological use of glucocorticoids. Truncal obesity and buffalo hump. Accelerated gluconeogenesis. Decreased resistance to infection. Decreased inflammatory response. Mineralocorticoid activity of cortisol results in e.g. hypertension, edema and alkalosis. ACTH stimulates not only glucocorticoid production but also weak androgens, so the excess ACTH in this syndrome can lead to presentation of male pattern baldness and cliteromegaly. Cushing's Syndrome - Answers Excess cortisol production because of tumor but this is at the level of the adrenal cortex. Will not see excess ACTH in Cushing's Syndrome but you do in Cushing's Disease. Because cortisol seeks to increase blood glucose levels, it will use whatever materials are available, including healthy tissue which will drive mobilization of fat stores into the anterior abdominal region. Conn's Syndrome (Primary Aldosteronism) - Answers Mineralocorticoid excess due to adenomas of the glomerulosa cells. Symptoms include hypertension, edema and alkalosis. Renin and angiotensin II levels are depressed. Secondary Aldosteronism - Answers Hyperplasia and hyperfunction of juxtaglomerula cells due renal artery stenosis and the attendant decrease in perfusion pressure results in elevated levels of renin and angiotensin. Congenital Adrenal Hyperplasia - Answers Due to deficiency in steroidogenic enzymes. 90% are due to 21-hydroxylase deficiency, others mainly an 11b-hydroxylase deficiency. Overproduction of ACTH. Overproduction of adrenal androgens leading to increased body growth, virilization, and ambiguous external genitalia. von Gierke's Disease (Type Ia) - Answers Due to a deficiency in Glucose 6-phosphatase. Symptoms: hypoglycemia, lack of glycogenolysis induced by epinephrine and glucagon. Andersen's Disease - Answers Defect in the glycogen branching enzyme. Leads to liver cirrhosis and abnormal glycogen, reduction in blood lactate and pyruvate after exercise; no post exercise drop in pH; normal hyperglycemic response to epinephrine McArdle's Disease - Answers Due to a deficiency in muscle glycogen phosphorylase. Leads to high muscle glycogen, reduction in blood lactate and pyruvate after exercise; no post exercise drop in pH; normal hyperglycemic response to epinephrine. Primary Hypogonadism - Answers Inability to secrete testosterone, leads to testicular failure. Testicular failure leading to failure to develop secondary sex characteristics or regression of these characteristics - depends on the time of onset of the disease. Small penis.