Addison's and Cushing's and Pheochromocytoma

Question 1

What is the inner layer of the adrenal gland?

Answer 1

Medulla

Question 2

What is the outer layer of the adrenal gland?

Answer 2

Cortex

Question 3

What does the adrenal cortex release?

Answer 3

Glucocorticoids, Mineralocorticoids, Androgenic hormones

Question 4

What does the adrenal medulla release?

Answer 4

Catecholamines
-Epinephrine (heart rate and respiratory rate)
-Norepinehrine (blood pressure)

Question 5

What are examples of the different steroids in the adrenal cortex?

Answer 5

1. Cortisol (stress hormone) and glucose
2. Aldosterone
3. Estrogen and testosterone

Question 6

What is the cause of Addison’s disease?

Answer 6

1. Hypofunctional adrenal gland
2. Autoimmune condition

Question 7

What are the manifestations of Addison’s in terms of hormones?

Answer 7

Low sugar, salt, androgen, and norepi but high epi

Question 8

What are the manifestations of low sugar?

Answer 8

1. Inability to tolerate stress (cortisol)
2. hypoglycemia
3. Inability to produce melanin stimulating hormone

Question 9

What is a common symptoms of Addison’s patients in terms of skin?

Answer 9

Bronze skin

Question 10

What are the manifestations of low salt?

Answer 10

1. Fluid Volume Deficit
2. Hyonatremia and Hyerkalemia
   - Altered LOC
   - Seizure

Question 11

What are the manifestations of low androgens?

Answer 11

Poor amount of axillary/pubic hair

Question 12

What is the manifestation of low norepinephrine?

Answer 12

Hypotension

Question 13

Why does the epinephrine increase instead of decrease?

Answer 13

Acts as a compensatory mechanism

Question 14

What are the manifestations of Addisonian Crisis?

Answer 14

Tachycardia, tachypnea, hypotension

Question 15

What is the management of Addisons?

Answer 15

1. Reduce stress
2. High sodium low potassium diet

Question 16

What drugs are given to patients with Addisons?

Answer 16

1. Prednisone (gluco)
2. Fludrocortisone (mineral)
   - WOF infection
   - take with food

Question 17

What causes Cushing’s?

Answer 17

High ACTH
1. Tumor
2. Autoimmune condition

Question 18

What occurs in Cushing’s?

Answer 18

Opposite of Addison’s, everything goes up

Question 19

What is the manifestation of high sugar?

Answer 19

1. Irritability (high cortisol)
2. Hyperglycemia
   - sluggish blood flow
   - risk for infection and fracture

Question 20

What is manifestation of high salt?

Answer 20

1. hypernatremia
   - altered LOC
   - seizure
2. Fluid Volume Excess

Question 21

What are the manifestations of fluid volume excess in cushing’s

Answer 21

1. Moon face
2. Buffalo hump
3. Truncal obesity
4. Weight gain

Question 22

What is the manifestation of high androgen?

Answer 22

1. Hirsutism (hair growth in female)
2. Gynecomastia

Question 23

What is the manifestation of high epi and norepi?

Answer 23

Hyertensive crisis (tachycardia, tachypnea, hypertension)
- risk for MI

Question 24

What is the management of Cushing’s?

Answer 24

1. Monitor intake and output
2. Weight monitoring
3. Monitor for infection (hyperglycemia)
4. Low sodium and high potassium diet

Question 25

What is the DOC for Cushing’s?

Answer 25

Mitotane (reduces cortisol)

Question 26

What is the surgical intervention for Cushing’s?

Answer 26

Adrenalectomy

Question 27

What is a Pheochromocytoma?

Answer 27

Tumor on the adrenal gland, does not affect the adrenal cortex

Question 28

What are the 5 P’s of Hypertensive Crisis?

Answer 28

1. Palpitations
2. Pressure
3. Perspiration
4. Pallor
5. Pain in the head

Question 29

What is the management of pheochromocytoma?

Answer 29

1. No palpation (may disturb the adrenal gland)
2. No heating

Question 30

What is the DOC for hypertensive crisis?

Answer 30

1. Hydralazine
2. Sodium nitroprusside

Question 31

What is the surgical intervention for pheochromocytoma?

Answer 31

Adrenalectomy