Adrenal Flashcards
how long should you continue sick day dosing?
48 hours or if prescribed antibiotics continue to double dose until finish the course or feel completely back to normal states
what to do if person vomits within 30 mins of taking steroids?
take dose again
If person vomits after 2nd attempt at taking steroids then what should they do?
inject steroid dose
If someone has NE predominant catecholamine elevation and you do imaging and it shows no adrenal nodule then what condition should you be suspicious for and what is your next step to work it up?
need to work up paragangliomabu doing FDG-PET/CT imaging
Within how many months should you do an ACTH stimulation test?
Should do before 2-3 month mark
When is DHEA-S level helpful
DHEA-S level is helpful if cortisol is between 9-14.
What level of DHEA-S indicates adequate cortisol production if serum cortisol level is intermediate?
If DHEA-S is >65 you can be confident that pt does not have adrenal insufficiency
What test can you consider using if albumin and CBG are abnormal in a patient in order to evaluate cortisol production?
salivary cortisol test in the morning
what is the target of renin for patients with primary aldosteronism on treatment?
historically target renin more than 1 but more individualized treatment may be needed especially for CKD patients
How does CKD impact renin?
CKD decreases renin
how does beta blockers impact renin?
Beta blockers suppress renin
general guideline for what is the better medication for acute hyperkalemia vs chronic hyperkalemia
Lokelma better for acute hyperkalemia and patiromer
What is the cut off to rule out adrenal insufficiency?
more than 15 rule out adrenal insufficiency (used to be more but now lower reference due to assay being more sensitive)
Treatment of adrenal crisis via IV steroids
Hydrocortisone 100mg IV stat and then 50mg IV every 8 hours
When do you need to do synthetic glucocorticoid screen?
??? (red top; miscellaneous order)
