Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SU18: Internal med final > Adrenal Insufficiency > Flashcards

Adrenal Insufficiency Flashcards

1
Q

zona glomerulosa (adrenal cortex) releases which hormones?

A

mineralcorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

role of mineralcorticoids

A

regulate mineral balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

example of mineralcorticoid

A

aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

zona fasciculata (adrenal cortex) releases which hormones?

A

glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

role of glucocorticoids

A

regulate glucose metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

example of glucocorticoid

A

cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

zona reticularis (adrenal cortex) releases which hormones?

A

androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

adrenal medulla releases which hormones?

A

stress hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

role of stress hormones

A

stimulate sympathetic ANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

examples of stress hormones

A

epi and norepi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

effect of cortisol

A
  • increases blood levels and use of glucose
  • increases BP
  • has anti-inflammatory actions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which hormone released by the adrenal gland is important to dentistry?

A

cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

regulation of cortisol secretion

A
  • hypothalamus releases corticotropin-releasing hormone
  • pituitary produces and secretes adrenocorticotropic hormone
  • ACTH stimulates adrenal cortex to produce and release cortisol
  • plasma cortisol levels increased within minutes
  • circulating cortisol inhibits CRH and ACTH
  • negative feedback loop
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what mediates circadian rhythm and stress response

A

CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what heavily regulates the cortisol secretion?

A

brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the #1 reason why pts secrete large amounts of cortisol?

A

surgical stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

adrenal fatigue

A

pts in a constant state of stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how many types of adrenal insufficiency are there?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

primary adrenocortical insufficiency

A
  • Addison disease

- adrenal cortex destroyed or removed (prob with adrenal cortex itself)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

med management of primary adrenocortical insufficiency

A
  • manage adrenal disease
  • lifelong hormone replacement
  • hydrocortisone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pts with primary adrenocortical insufficiency get replacement of which hormone?

A

aldosterone and glucocorticoid (cortisol)

22
Q

glucocorticoid replacement corresponds to how many mg of normal output a day?

A

~20 mg/day

23
Q

secondary adrenocortical insufficiency

A

pituitary disease or adrenals unresponsive to ACTH (adrenal gland not destroyed, just less responsive)

24
Q

med management of secondary adrenocortical insufficiency

A
  • glucocorticoid replacement

- hydrocortisone 10-20 mg/day

25
Q

tertiary adrenocortical insufficiency

A
  • sluggish hypothalamus
  • have to txt autoimmune and inflammatory disease AND long-term immunosuppression for organ transplant and joint replacement
26
Q

drug regimens for tertiary adrenocortical insufficiency pts are low doses in order to prevent what?

A

adrenal suppression

27
Q

T/F: HPA axis regains responsiveness after dosage of steroids in pts with tertiary adrenocortical insufficiency

A

true

28
Q

how long does it take for HPA axis to regain responsiveness and fxn after dosage of steroid?

A

14 days

29
Q

when are the cortisol levels the highest?

A

during and after surgery

30
Q

plasma cortisol peaks 2 to 10-fold between how many hours after surgery?

A

4-10 hours

31
Q

T/F: postoperative pain does not contribute to the high levels of cortisol after surgery

A

false, does contribute

32
Q

when does cortisol levels return to baseline?

A

24-48 hours post-op

33
Q

adrenal crisis

A

life-threatening emergency

34
Q

signs and syms of adrenal crisis

A
  • hypotensive collapse
  • abdominal pain
  • myalgia
  • fever
35
Q

what can cause an adrenal crisis in pts with adrenal insufficiency?

A
  • stress
  • infection
  • pre/post-op
36
Q

txtment for pts with adrenal crisis?

A
  • immediate txtment in ED
  • 100 mg hydrocortisone bolus
  • fluids and electrolytes
37
Q

does adrenal crisis occur more often in pts with primary, secondary or tertiary adrenocortical insufficiency?

A

primary

38
Q

what percent of primary adrenocortical insufficiency pts have an adrenal crisis annually?

A

8%

39
Q

routine dentistry steroid supplementation for primary adrenocortical insufficiency pts

A

none

40
Q

routine dentistry steroid supplementation for secondary adrenocortical insufficiency pts

A

none

41
Q

minor surgery steroid supplementation for primary adrenocortical insufficiency pts

A

25 mg of hydrocortisone equivalent, pre-op on day of surgery

i.e. EXT or periodontal surgery

42
Q

minor surgery steroid supplementation for secondary adrenocortical insufficiency pts

A

daily therapeutic dose

43
Q

moderate surgical stress steroid supplementation for primary adrenocortical insufficiency pts

A
  • 50-75 mg on day of surgery and up to 1 day after
  • return to pre-op glococorticoid dose on post-op day 2
    (i. e. 4 quad of alveloplasty, full mouth EXT, tori removal)
44
Q

moderate surgical stress steroid supplementation for secondary adrenocortical insufficiency pts

A

daily therapeutic dose

45
Q

when is the cortisol level the highest in ppl?

A

the mornings

46
Q

cortisol is released according to what?

A

circadian rhythm

47
Q

dental mods for pts with adrenal insufficiency

A
  • stress reduction
  • morning appts
  • pain control
  • monitor BP during surgery
48
Q

pain control in pts with adrenal insufficiency

A
  • pre-emptive analgesia

- long-acting LA

49
Q

hypotensive BP

A

<100/60

50
Q

what is one of the first signs of adrenal crisis

A

hypotension

51
Q

what are some other signs of adrenal crisis

A

dizziness and/or syncopy

52
Q

what do you do during an acute adrenal crisis?

A
  • EMS
  • position pt to support cerebral oxygenation in face of hypothension
  • BLS

SU18: Internal med final (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions