Adrenal gland

Question 1

condition resulting form hyper secretion of glucocorticoids and also in this location?

Answer 1

cushing syndrome; adrenal cortex

Question 2

what hormone from the pituitary causes Cushing Syndrome?

Answer 2

increased pituitary secretion of the adrenocorticotropic hormone, pituitary adenoma, adrenal adenoma

Question 3

what is secreted endogenously from a patient who has Cushing Syndrome?

Answer 3

Pituitary hypersecretion of ACTH

Adrenal hypersecretion of cortisol (adenoma, carcinoma, nodular hyperplasia)

Ectopic ACTH (small cell lung cancer)

Question 4

how can a patient develop cushing syndrome exogenously?

Answer 4

Administration of exogenous glucocorticoids

Question 5

these are the clinical features of a patient with Cushing Syndrome?

Answer 5

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

Question 6

what are the diagnostic parameters for someone with Cushing Syndrome?

Answer 6

Increased Na and blood glucose levels, decreased K, reduction in eosinophils, disappearance of lymphoid tissue

Urine cortisol levels

Overnight dexamethasone suppression test

Question 7

how can Cushing Syndrome be treated?

Answer 7

Surgical removal of tumor, radiation

Question 8

this medical condition is due to the Hyposecretion of adrenal cortex hormones (glucocorticoids and mineralocorticoids)?

Answer 8

Addison’s disease

Question 9

what are the causes of Addison’s disease?

Answer 9

autoimmune/idiopathic atrophy of adrenal glands, surgical removal, infection, inadequate secretion of ACTH from the pituitary gland, use of corticosteroids

Question 10

how can Addison’s disease be assessed?

Answer 10

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

Question 11

what are the s/s of someone with Addison’s disease crisis?

Answer 11

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

Question 12

what are the diagnostic parameters of someone with Addison’s disease?

Answer 12

Hypoglycemia, hyponatremia, hyperkalemia, leukocytosis

Confirmation: low adrenocortical hormone levels in blood or urine and decreased serum cortisol levels

Question 13

how do we manage a patient with Addison’s disease?

Answer 13

Immediate tx to prevent shock, IV dextrose, vasopressors, Abx

Question 14

this medical condition is due to the overproduction of aldosterone?

Answer 14

Conn’s Syndrome, so this is due to adrenal cortex issues (mineralocorticoid or glucocorticoid deficiency/excess)

Question 15

how does Conn’s Syndrome usually present?

Answer 15

adenoma, bilateral adrenal hyperplasia or carcinoma

Question 16

what are s/s of Conn’s Syndrome?

Answer 16

headache, hypokalemia causing muscle weakness, nocturnal polyuria, hand cramping

Question 17

how can we treat Conn’s Syndrome?

Answer 17

Adenoma removal, medical tx for hyperplasia w/ sprinolactone

Question 18

this medical condition is due to the hypersecretion of catecholamines(epi and norepi) activate fight/flight response

Answer 18

pheochromocytoma from secreting tumors of the medulla

Question 19

how do we assess a patient with pheochromocytoma?

Answer 19

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)

Question 20

how should we plan to care for someone with pheochromocytoma?

Answer 20

Avoid physical/emotional stress, encourage rest, frequent bathing, stay warm, analgesics, sedatives, ample diet, avoid stimulants, self care, post-surgical adrenalectomy or medullectomy

Question 21

what is this the medical condition when there is an Adrenal gland failure d/t bleeding into the adrenal gland?

Answer 21

Waterhouse-Friderichsen syndrome caused by severe meningococcal infection or other severe, bacterial infection

Question 22

what are the symptoms of Waterhouse-Friderichsen syndrome?

Answer 22

acute adrenal gland insufficiency, profound shock. Deadly without treatment. Adrenal apoplexy.