12: Adrenal Diseases - Thompson

Question 1

what does cortisol do?

Answer 1

regulates BP
cardiac function
immune system
mood
insulin metabolism

Question 2

what does aldosterone do?

Answer 2

• BP
• water balance
• na balance
• helps kidneys keep Na and get rid of K

Question 3

growth on the adrenals leads to increased production of epi and NE

Answer 3

pheochromocytoma

Question 4

10% tumor

Answer 4

pheochromocytoma - only 10% of the time are they the following things:

malignant
2 side
in kids 
familial 
recur

Question 5

sign and symptoms of pheochromocytoma

Answer 5

rapid HR
high BP
flushed
anxiety
pale 

you should be suspicious when BP not being controlled with meds

get 24 hr urine metanephrines or catecholamines

Question 6

from a lack of epi/NE

Answer 6

autonomic failure

Question 7

POTS postural orthostatic tachycardic syndrome

Answer 7

fainting, CP, SOB, fatigue

meds to treat symptoms

Question 8

failure of adrenals to make enough cortisol

Answer 8

addison’s disease

lack of ACTH from pituitary dysfunction or lack of adrenal function (primary cause- autoimmune)

Question 9

what type of addisions will keep making aldosterone?

Answer 9

secondary (pituitary dysfunction with lack of ACTH)

Question 10

wt loss
fatigue
low BP
darkening of skin

Answer 10

addisons

Question 11

key electrolyte balance for addisons ***

Answer 11

low Glu
low Na
high K

Question 12

not enough cortisol and patient gets sick

Answer 12

addison’s crisis

steroids - pretreat to avoid with things like surgery

again **low blood sugar, low Na, high K

Question 13

addisons - give synthetic ACTH, what do you see?

Answer 13

should see increase in cortisol in normal ppl

no increase in addisons

Question 14

cushings syndrome v. disease

Answer 14

syndrome when caused by adrenal issue

disease when caused by pit. tumor

Question 15

hyperglycemai, hypernatremia, hypokalemia

Answer 15

cushings

Question 16

giving steroids for too long and too much

Answer 16

iatrogenic cushings may develop

Question 17

if cortisol is high, then…

Answer 17

dexamethasone suppresion test (give steroids, body should decrease its own production

Question 18

new med that reduces cortisol in cushings disease

Answer 18

signifor

Question 19

should you give extra steroids to a cushing’s pt during stress like you do with addisons?

Answer 19

actually yes

because neither can regulate

Question 20

hyperaldosteronism =

Answer 20

conn’s disease

may be 5-15% of hypertensives

Question 21

treatment for conn’s disease

Answer 21

spiranolactone

Question 22

htn, low K, HA, muscle weakness

Answer 22

conn’s

suspect hyperaldosteronism in pt with resistant htn and low potassium

Question 23

what glucose issue can be present in up to 20% of those with Conn’s?

Answer 23

glucose intolerance

Question 24

what acid-base issue may those with conn’s have?

Answer 24

metabolic alkalosis due to low potassium - hydrogen leaves with potassium