Adrenal gland Flashcards
condition resulting form hyper secretion of glucocorticoids and also in this location?
cushing syndrome; adrenal cortex
what hormone from the pituitary causes Cushing Syndrome?
increased pituitary secretion of the adrenocorticotropic hormone, pituitary adenoma, adrenal adenoma
what is secreted endogenously from a patient who has Cushing Syndrome?
Pituitary hypersecretion of ACTH
Adrenal hypersecretion of cortisol (adenoma, carcinoma, nodular hyperplasia)
Ectopic ACTH (small cell lung cancer)
how can a patient develop cushing syndrome exogenously?
Administration of exogenous glucocorticoids
these are the clinical features of a patient with Cushing Syndrome?
HTN, weight cain (truncal obesity, moon face, buffalo hump), decreased muscle mass, catabolic effect on proteins w/ loss of collagen (cutaneous striae, easy bruising, osteoporosis), hirsutism, amenorrhea, increased risk of infection, supravicular fat pads, increased Na, decreased Ca and K
what are the diagnostic parameters for someone with Cushing Syndrome?
Increased Na and blood glucose levels, decreased K, reduction in eosinophils, disappearance of lymphoid tissue
Urine cortisol levels
Overnight dexamethasone suppression test
how can Cushing Syndrome be treated?
Surgical removal of tumor, radiation
this medical condition is due to the Hyposecretion of adrenal cortex hormones (glucocorticoids and mineralocorticoids)?
Addison’s disease
what are the causes of Addison’s disease?
autoimmune/idiopathic atrophy of adrenal glands, surgical removal, infection, inadequate secretion of ACTH from the pituitary gland, use of corticosteroids
how can Addison’s disease be assessed?
Lethargy, fatigue, muscle weakness, GI disturbances, weight loss, menstrual changes in women, impotence in men, postural hypotension, dehydration, emotional disturbances, bronze pigmentation of skin, decreased BP
what are the s/s of someone with Addison’s disease crisis?
Characterized by cyanosis and classic signs of circulatory shock: pallor, rapid and weak pulse, rapid respirations, decreased blood pressure
Pt may complain of HA, nausea, abd pain, diarrhea, confusion, restlessness
what are the diagnostic parameters of someone with Addison’s disease?
Hypoglycemia, hyponatremia, hyperkalemia, leukocytosis
Confirmation: low adrenocortical hormone levels in blood or urine and decreased serum cortisol levels
how do we manage a patient with Addison’s disease?
Immediate tx to prevent shock, IV dextrose, vasopressors, Abx
this medical condition is due to the overproduction of aldosterone?
Conn’s Syndrome, so this is due to adrenal cortex issues (mineralocorticoid or glucocorticoid deficiency/excess)
how does Conn’s Syndrome usually present?
adenoma, bilateral adrenal hyperplasia or carcinoma
what are s/s of Conn’s Syndrome?
headache, hypokalemia causing muscle weakness, nocturnal polyuria, hand cramping
how can we treat Conn’s Syndrome?
Adenoma removal, medical tx for hyperplasia w/ sprinolactone
this medical condition is due to the hypersecretion of catecholamines(epi and norepi) activate fight/flight response
pheochromocytoma from secreting tumors of the medulla
how do we assess a patient with pheochromocytoma?
Persistent HTN, increased HR, palpitations, weight loss, hyperglycemia, glucosuria, polyuria, pallor, tremor, nervousness, weakness, visual disturbance, pain, histamine test, VMA test (vanillylmandelic acid is a product of catecholamine breakdown)
how should we plan to care for someone with pheochromocytoma?
Avoid physical/emotional stress, encourage rest, frequent bathing, stay warm, analgesics, sedatives, ample diet, avoid stimulants, self care, post-surgical adrenalectomy or medullectomy
what is this the medical condition when there is an Adrenal gland failure d/t bleeding into the adrenal gland?
Waterhouse-Friderichsen syndrome caused by severe meningococcal infection or other severe, bacterial infection
what are the symptoms of Waterhouse-Friderichsen syndrome?
acute adrenal gland insufficiency, profound shock. Deadly without treatment. Adrenal apoplexy.
