Endocrinology Exam 2| 262 QUESTIONS| WITH COMPLETE SOLUTIONS

What is Cushing's? What are the two major classes? correct answer: hyperadrenocorticism: excess production of cortisol from the adrenal cortex - spontaneous is either from excess pituitary secretion of ACTH (pituitary-dependent) or from a functional adrenocortical tumor - with spontaneous Cushing's, 85% is PDH and 15% is adrenal-dependent - iatrogenic is from excess administration of exogenous glucocorticoid Describe the regulation of the release of cortisol from the adrenal glands correct answer: - CRH is released from the hypothalamus in response to stress or serotonin, which stimulates the release of ACTH from the anterior pituitary - in response to ACTH, the adrenal cortex (zona fasciculata) releases cortisol to go to target tissues - with sufficient cortisol stimulation, What are the possible etiologies of pituitary-dependent hyperadrenocorticism? correct answer: - most are functional (ACTH-secreting) pituitary neoplasia; most commonly these are microadenomas; macroadenomas are less common and adenocarcinoma is rare - neoplasia can occur in either pars distalis or pars intermediate of the anterior pituitary - rarely pituitary hyperplasia that may result from excess CRH stimulation