Adrenal + Parathyroid Flashcards

1
Q

what 2 hormones do the adrenal glands release?

A

aldosterone

cortisol

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2
Q

what hormone does cortisol inhibit?

A

insulin

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3
Q

does cortisol increase or decrease sugar levels?

A

increase

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4
Q

what are the 2 main causes of cushing’s syndrome?

A

*1. steroid drug use

  1. tumors secreting cortisol or ACTH (MC adrenal)
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5
Q

what are some s/s of cushing’s syndrome?

A

central obesity (moon face, buffalo hump)

catabolic effects (wasting, thin skin)

diabetes

hypertension

osteopenia/porosis

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6
Q

what lab test diagnoses cushing’s syndrome?

A

dexamethasone suppression test

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7
Q

what should normally happen when you administer dexamethasone?

A

suppresses ACTH/cortisol

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8
Q

what should you think if you administer dexamethasone and there is no response?

A

tumor secreting ACTH/cortisol

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9
Q

for cushings syndrome, what do you measure in a 24h urine?

A

free cortisol : creatinine

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10
Q

how do you treat cushings disease (if not caused by steroids)

A

resect tumor

postop cortisol

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11
Q

why do we taper steroids

A

may cause chronic suppression of adrenal glands when quickly d/c

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12
Q

what should you suspect in anyone with fatigue, weakness, or HoTN w/ really nonspecific sx?

A

adrenal insufficiency

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13
Q

what is an autoimmune cause of adrenal insufficiency?

A

addison’s disease

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14
Q

when do you check cortisol levels for someone with adrenal insufficiency?

A

in the morning

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15
Q

what will you see on CT scan of someone with addisons?

A

non-calcified, small adrenals

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16
Q

how do you diagnose adrenal insufficiency?

A

cosyntropin (synthetic ACTH) stimulation test

17
Q

how do you treat adrenal insufficiency?

A

gluco/mineralcorticoid replacement

diurnal pattern

18
Q

by how much must you increase glucocorticoid replacement therapy during times of stress?

A

8-10x

19
Q

what should you suspect in someone with suppressed adrenals + a stress event that has HoTN that doesn’t respond?

A

acute adrenal insufficiency

20
Q

how do you tx acute adrenal insufficiency?

A

IV hydrocortisone

rapid isotonic fluids

21
Q

why are you so rapidly giving fluids for acute adrenal insufficiency?

A

it’s a life-threatening emergency

22
Q

what rare cause of 2ndary HTN is caused by a tumor of the adrenal medulla that increases NE and epi?

A

pheochromocytoma

23
Q

how might a pt present with pheochromocytoma

A

sustained HTN

bad HA

sweating

palpitations

24
Q

how do you diagnose pheochromocytoma?

A

24h urine for catecholamines + metanephrines

25
Q

how do you tx pheochromocytoma?

A

surgery

+ alpha blockers + beta blockers

26
Q

what does PTH do?

A

calcium homeostasis

osteoclastic activity

27
Q

if a person has hypoparathyroidism, will Ca be high or low

A

low

28
Q

what deficiency may hypoparathyroidism lead to?

A

Mg

29
Q

what are some of the more unique s/s or hypoparathyroidism?

A

carpopedal spasm

seizures

paresthesias

personality changes

Chvostek’s sign + Trosseau’s sign

dry, thin nails, hyperactive reflexes

30
Q

in hypoparathyroidism will PO4 be high or low

A

high

31
Q

in hyperparathyroidism is Ca high or low

A

high

32
Q

hyperparathyroidism is usually an incidental finding, but what might clue you into the dx?

A

” psychic moans, abdominal groans, kidney stones, painful bones”

33
Q

how do you treat hyperparathyroidism?

A

NS + furosemide

34
Q

what are the qualifications for surgery on hyperparathyroidism?

A

if sx: must have bone disease or stones

if asx: must have low bone density, be in 2nd trimester, or not have calcuria