Adrenal Insufficiency, Addisons, Cushings, Pheocytochtoma, Aldosteronism

Front 1

What does the adrenal cortex secrete? 5

Back 1

Androgens (sex)
Glucocorticoids (sugar)
Mineralocorticoids (salt)
Cortisol
Aldosterone

Front 2

What does the adrenal medulla secrete? 2

Back 2

epi and norepi (catecholamines)

Front 3

What monitors how much of each solute is in the blood?

Back 3

hypothalamus

Front 4

What is Addison's disease?

Back 4

An adrenal insufficiency that is low in renin, androgens, gluco's, and mineralo's.

Front 5

What is Cushing's disease?

Back 5

Adrenal overactivity characterized by high levels of androgens, gluco's, and mineralo's.

Front 6

What is primary adrenal insufficiency?

Back 6

Addison's disease

Front 7

What are other causes of adrenal insufficiency?

Back 7

Idiopathy. Autoimmune.TB.

Front 8

Name four risks associated with obtaining adrenal insufficiency?

Back 8

Using glucocorticoids for more than 3 weeks with abrupt halt.

endocrine disorder hx

removal of one adrenal gland

chronic steroid use

TB,AIDS,Metastasis,Cytomegaly and Histoplasmosis

Front 9

Name the 11 manifestations of addison's disease and adrenal insufficiency?

Back 9

1.nausea
2.vomiting
3.bronzing
4.anorexia
5.weight loss
6.fatigue
7.irribility
8. postural hypotension
9.low cortisol levels with high acth in primary
10.hyponatremia,hyperkalemia,and hypoglycemia

Front 10

What are serum electrolytes like for adrenal insufficiency?

Back 10

hyponatremia, hypoglycemia, and hyperkalemia

Front 11

What occurs during an Addison's Crisis?

Back 11

The person is stressed, but does not have enough hormones to conquer it.

Front 12

What kind of things can bring on an Addison's crisis?

Back 12

surgery, pregnancy, vomiting, d'hea,trauma,infection,dehydration

Front 13

A person presents with a change in mental status, a bp of 90/60 when he stands, and has severe pain in back,abdomen, and legs. He is having problems with his memory.The doctor describes him as bring "dry". What is he experiencing?

Back 13

Addison's crisis

Front 14

How would you treat Addison's crisis?

Back 14

1.Isotonic solution to replace fluids and electrolytes
2. Replace glucose with 5% dextrose infusion
3. Replace steroids with hydrocortisone IV then progress to PO as stabilized

Front 15

What can you give to decrease potassium levels in hyperkalemia?

Back 15

kayexalate

Front 16

What should you do if you have Addison's disease and are vomiting?

Back 16

Give your steroids through IM injection

Front 17

What is secondary adrenal insufficiency due to?

Back 17

some kind of problem within the hypothalmus-pituitary-adrenal gland network

Front 18

Why is hypopituitarism a player in 2ndary adrenal insuff?

Back 18

There is a decrease by the pituitary gland for secretion of ACTH. This results in low plasma ACTH

Front 19

hyperaldosteronism: What do labs looks like concerning aldosterone,cortisol, steroid levels, and acth in the plasma?

Back 19

Aldosterone plenty
Cortisol low
Steroid plenty
ACTH low

Front 20

When does pl who have 2ndary addison's disease experience manifestations?

Back 20

They do not until there is an abrupt withdrawal from steroid therapy or if a tumor is resected.

Front 21

What are the five causes of 2ndary adrenal insufficiency?

Back 21

hypopituitarism,pituitary infarction,pituitary tumor,radiation,corticosteroid administration

Front 22

What is Cushing's syndrome causes by?

Back 22

-cortisol secreting tumor
-pituitary hypersecretion
-pituitary tumor
-oat cell carcinoma tumor secretes aCTH
-excessive steroid use

Front 23

Name the 14 signs and symptoms of Cushing's disease/

Back 23

1. truncal obesity
2.hyperglycemia
3. striae
4. virilism
5.hypokalemia
6.hypernatremia
7. mental status changes
8. osteroporosis
9.abnormal fat distribution
10.edema
11.protein wasting
12. fragile capillaries
13.risk of infection
14. hypertension

Front 24

What do electrolyte levels look like with Cushing's syndrome?

Back 24

1. hyperkalemia
2.hyponatremia
3.hyperglycemia

Front 25

What do serum cortisol levels look like with Cushing's?

Back 25

increased day and night

Front 26

How do you treat Cushings?

Back 26

adrenalectomy or hypophysectomy (pituitary surgery)

Front 27

What do people with adrenalectomies have to do for a lifetime?

Back 27

steroid replacement therapy

Front 28

Why are patients experiencing adrenal insufficiency postop?

Back 28

HPA axis supressed

Front 29

What kind of diet should a Cushing's syndrome patient be on?

Back 29

low cal, carb, and salt diet

Front 30

What can you do for adrenal glands that are unresectable or for palliative care?

Back 30

Give adrenal block agent, ACTH reducing agent, or radiation therapy

Front 31

Name some adrenal blocking agents.

Back 31

Lysodren, ammogluthethimide, trilostane

Front 32

How do lysodren. ammogluthethimide, and trilostane work?
Who should get them?

Back 32

The block the creation of corticoid synthesis without destroying cells

-ppl who cannot have surgery with cushing's

Front 33

Name some acth reducing agents.

Back 33

periactin,bromocriptine,somatostatin

Front 34

How do periactin,somatostatin,bromocriptine work?

Back 34

They prevent hypersecretion of ACTH.

Front 35

What is the primary role of aldosterone?

Back 35

NA conservation and promotes K excretion. Reabsorb wata and salt..get rid or potassium and hydrogen ions

Front 36

How is aldosterone regulated?

Back 36

Renin-angiotensin system

Front 37

How does aldosterone exhibit if there is low salt, high potassium, and increased ACTH levels?

Back 37

Metabolic alkalosis and effects aldosterone production

Front 38

What causes hyperaldosteronism?

Back 38

adrenal lesion that secretes too much

Front 39

What is Conn's syndrome?

Back 39

excessive amounts of aldosteronism =hi na,low k, and high blood pressure

Front 40

Name six secondary causes of hyperaldosteronism.

Back 40

1. laxative/diuretic abuse
2. renal disease
3.liver disease
4.heart failure
5.dehydration
6.decreased intravasc volume

Front 41

What occurs with salt and water during hyperaldosteronism?

Back 41

too much salt and water are saved and too much potassium is excreted

Front 42

Do hyperaldosteronism have edema?

Back 42

no

Front 43

What is the two types of treatment for hyperaldosteronism?

Back 43

Surgery -adrenalectomy or
spirinolactones to treat BP to exrete sodium and conserve K

Front 44

What should be given if patient cannot tolerate aldactone?

Back 44

amiloride

Front 45

What are seven side effects of spirinolactone?

Back 45

1. decreased libido
2. gi problems
3. gynecomastia
4.menstrual ireg
5.impotence
6. digoxin extends half life
7. salicylates decrease effectiveness

Front 46

What is the significance of adrenomedullary disorders?

Back 46

The person is in constant fight or flight responses due to the tumor.

Front 47

What tumor causes hyperactivity or adrenal medulla?

Back 47

pheochromocytoma

Front 48

What malignant tumor of the nervous system is found in infants and children/

Back 48

neuroblastoma

Front 49

A person comes into the ER with sweating, tacycardia,headache,high sugar,high bp, and is emotionally unstable. What seems to be the problem?

Back 49

There is a tumor on the adrenal medulla called a pheochromocytoma that is putting him into a constant fight or flight.

Front 50

What is the risk of surgery related to pheochromocytoma?

Back 50

release of epi and norepi with increased bp and cardiac dysrhythmia

Front 51

What is important before an adrenalectomy r/t pheochromocytoma?

Back 51

-Manage complications especially hypertension preoperatively

Front 52

Name the six functions of epi and norepi.

Back 52

1. increased rate and heart contraction
2. dilation of bronchioles
2. vasoconstriction
4. lipolysis
5.increases metabolism
6.inhibits non-essential processes