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CMPA412 > Adrenal Diseases > Flashcards

Adrenal Diseases Flashcards

1
Q

also known as suprarenal gland, small triangular shapes gland located on the top of the both kidneys. 4-5 grams in weight.

A

Adrenal Gland

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2
Q

is the outermost region of the adrenal cortex and is the only zone of the adrenal gland that contains the enzyme aldosterone synthase (CYP11B2)

A

Zona Glomerulosa

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3
Q

the middle zone of the adrenal cortex secretes glucocorticoids which are important for carbohydrate, protein and lipid metabolism. (Regulates blood sugar)

A

Zona Fasiculata

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4
Q

produces androgens (sex hormones)

A

Zona Reticularis

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5
Q

ZG: Mineralocorticoids

A

Aldosterone

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6
Q

ZF: Glucocorticoids

A

Cortisol
Prednisone

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7
Q

ZR: Sex Hormones

A

Androgen
Estrogen

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8
Q

Adrenal Medulla releases ?

A

Cathecolamines

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9
Q

AM: Cathecolamines

A

Norepinephrine
Epinephrine
Dopamine

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10
Q

Hyposecretion of Aldosterone & Cortisol

A

Addison’s Disease

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11
Q

Addison’s Cause: Primary adrenal insufficiency?

A

Hyposecretion of adrenal cortex hormone
Mineralocorticoids
Glucocorticoids
Androgens

Autoimmune

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12
Q

Addison’s Cause: Secondary adrenal insufficiency?

A

Hyposecretion of adrenal cortex hormones
Hyposecretion of ACTH from anterior pituitary gland
Mineralocorticoids release is spared

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13
Q

Addison’s CM: Sugar and Salt Levels?

A

Hypoglycemia
Hyponatremia

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14
Q

Addison’s CM: Tired and Muscle?

A

Weakness

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15
Q

Addison’s CM: Reproductive Organs in Fm and M?

A

Irregular Menstrual Cycle
Erectile Dysfunction

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16
Q

Addison’s CM: Electrolyte Levels Increase?

A

Hyperkalemia
Hypercalcemia

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17
Q

Addison’s CM: Skin?

A

Hyperpigmentation (Bronze-like)

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18
Q

Addison’s CM: Gastrointestinal Disturbance?

A

Diarrhea

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19
Q

Addison’s CM: Emotional Disturbance?

A

Depression

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20
Q

Addison’s CM: Blood Pressure?

A

Hypotension

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21
Q

Addison’s Intervention: Monitor for?

A

Glucose, K+, Na+, Ca+ Levels
VS
I and O
Weight

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22
Q

Addison’s CM: Weight?

A

Loss

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23
Q

Addison’s Intervention: Hormone Replacement Therapy?

A

Mineralocorticoid: Fludrocortisone (florinef)
Glucocorticoid: Prednisone, Hydrocortisone

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24
Q

Addison’s Intervention: Diet?

A

High CHO and CHON, enought salt

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25
Addison's Intervention: When taking glucocorticoids?
Calcium and Vitamin D supplements
26
Addison's Intervention: Glucocorticoids needa to be increased when?
Stress, Illness, Surgery
27
Addison's Intervention: Avoid?
Illness, Stress, Strenous Activities
28
the patient has extremely LOW CORTISOL levels (life threatening)
Addisonian Crisis
29
Addisonian Crisis 5s
Sudden pain in stomach, back, legs Syncope (unconcious) Shock Super Low BP Severe vomiting, diarrhea, headache
30
Addisonian Crisis Intervention
IV Cortisol Stat ( Solu-Cortef and D5NS)
31
caused by increased amounts of ACTH secreted by the pituitary gland
Cushing's Disease
32
is a metabolic disorder characterized by abnormally increased secretion (endogenous) of cortisol
Cushing's Disease
33
caused by an outside cause or medical treatment such as glucocorticoid therapy
Cushing's Syndrome
34
hyper-secretion of CORTISOL
Cushing's Disease
35
Cushing's CM: Fragile ? that easily bruises
Skin Ecchymosis
36
Cushing's CM: Truncal ? with ?
Obesity, Small Arms
37
Cushing's CM: face? , Dorsocervical?
Rounded, Moon face Fat, Buffalo hump
38
Cushing's CM: Reproductice Issues in Fm and M?
Amenorrhea, Hirsutism Erectile Dysfunction
39
Cushing's CM: Blood Sugar Levels?
Hyperglycemia
40
Cushing's CM: Electrolyte Levels
Hypernatremia Hypokalemia, Hypocalcemia
41
Cushing's CM: Blood Pressure?
Hypertension
42
Cushing's CM: Red-purplish ? on ?
Striae Abdomen, Back, and Thighs
43
Cushing's CM: General ? and ? wasting
Weakness Muscle
44
Cushing's Intervention: Prepare patient for ? to remove the pituitary tumor
Hypophysectomy
45
Cushing's Intervention: Prepare the client for ? if the condition results from an adrenal adenoma
Adrenalectomy
46
Cushing's Intervention: ? may be required following adrenalectomy
Glucocorticoid Replacement
47
Cushing's Intervention: Diet?
Low Calorie, Sodium High CHON, K+, Ca+ Vitamin Supplements
48
Cushing's DT: Measures the response of adrenal glands to ACTH. Dexamethasone ?mg is given ? at ?pm.
Dexamethasone Suppression Test (Confirmatory Test) Oral, 1mg, 11pm
49
Cushing's DT: It decreases in the evening- during early phase of sleep
Plasma Cortisol 10-20 mcg/dl
50
Cushing's MM: to decrease production of glucocorticoids
Mitotane (Lysodren)
51
Cushing's MM: Cortisol Receptor blocker
Korlym (Mifepristone)
52
hypersecretion of mineralocorticoids (aldosterone) from the adrenal cortex of the adrenal gland
Hyperaldosteronism/Conn's Syndrome
53
Seen more frequently in women (30-50 y/o) Cause by a tumor or hyperplasia of adrenal gland
Hyperaldosteronism/Conn's Syndrome
54
Seen more frequently in women (30-50 y/o) Cause by a tumor or hyperplasia of adrenal gland
Hyperaldosteronism/Conn's Syndrome
55
Conn's CM: Electrolyte Levels
Hypernatremia Hypokalemia
56
Conn's CM: ABG Analysis
Metabolic Alkalosis
57
Conn's CM: Cardiac ?
Dysrhythmias
58
Conn's DT: in supine position with normal sodium diet ? , with upright /standing position or seated for at least ? is 2-5x supine value
Plasma Aldosterone 2-9 ng/dl or 55-250 pmol/L 2hrs
59
Conn's DT: Urine Aldosterone
14-16 nmol/24hrs
60
Conn's CM: 2P
Polyuria Polydipsia
61
Conn's Triad
Hypertension, Hypokalemia, Metabolic Alkalosis
62
Conn's Intervention: Monitor
VS I and O Urine Specific Gravity Signs of Hypernatremia, Hypokalemia
63
Conn's Intervention: Maintain ? restriction as ordered
Sodium
64
Conn's Intervention: Administer ? and ? supplements as ordered
Spironolactone (Aldactone) Potassium
65
Conn's Intervention: Prepare the client for an ? if indicated
Adrenalectomy
66
Conn's Intervention: Health teaching after adrenalectomy
Glucocorticoid Replacement
67
Catecholamine-producing tumor usually found in the adrenal medulla, but extraadrenal locations include the chest, bladder, abdomen, and brain
Pheochromocytoma
68
Excessive amounts of E and NE are secreted
Pheochromocytoma
69
founds in the adrenal medulla and secrete catecholamines
Chromaffin Cells
70
Pheo CM: Face ?, Heart ?
Flushing Palpitations
71
Pheo CM: Increases?
BP, HR Glucose (Hyperglycemia) Anxiety, Fear
72
Pheo CM: Severe ?, Pain in ? with ?
Headaches Chest and Abdomen with NV
73
Pheo CM: ? Intolerance, Profuse ?
Heat Diaphoresis
74
Pheo CM: ? Loss, Tired and ?
Weight Weak
75
Pheo can be triggered by eating ? and medications such as ?
Tyramine rich foods MAOIs
76
Occurs most commonly between ages 25-50, hereditary in some cases
Pheochromocytoma
77
Pheo DT: is produced in the liver and is a major product of epinephrine and norepinephrine metabolism which is excreted in the urine
Vanillyl Mandelic Acid (VMA)
78
Pheo DT: Preparation - No food and fluid with ? for ? hours before the test - Normal level mg/24 hours
Coffee, Tea, Cocoa, Chocolate 48 hrs 2-7 mg
79
Pheo Intervention: Monitor closely ?
VS - BP and HR Hypertensive Crisis Glucose
80
Pheo Intervention: Instruct the client not to ?, drink ?-containing beverages, or change ? suddenly.
Smoke Caffeine Position
81
Pheo Intervention: Provide care for the client with an ? as ordered
Adrenalectomy
82
Pheo Intervention: Administer pre-opt ? (Cardura, Minipress, Hyrtin): work by blocking noradrenaline, reduces catecholamines
Alpha-adrenergic blockers
83
Pheo Intervention: may also be prescribe patient a ? like ? or ? to help with hypertension and tachycardia
Beta-adrenergic Blockers (Labetalol or Inderal)
84
Pheo Intervention: If patient is having a bilateral adrenalectomy (both glands removed ) - will have to take ? and ? for
Glucocorticoids, Mineralocorticoids Lifetime
85
Pheo Intervention: If patient is having a unilateral adrenalectomy (only one gland removed): will have to take ? for approximately ?
Glucocorticoids 2 Years
86
Pheo Intervention: Diet
High Calorie

CMPA412 (7 decks)

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