Adrenal Probs Flashcards
Hypercortisolism
Hyper secretion of cortisol hormone
primary hyperfunction
Disease of adrenal cortex
Too high of cortisol hormone levels
Cushing syndrome
secondary hyperfunction
Disease of anterior pituitary
Increased release of ACTH triggering hormone
Cushing disease
what is the most common cause of Cushing syndrome?
EXOgenous steroids
Function of cortisol
increases blood sugar, oppose insulin
Protects versus physiological effects of stress
Suppresses immune and inflammatory processes
Breaks down proteins and fat
Increases blood cholesterol
Maintains vascular system, keeps BP up
symptoms with too much cortisol
Increased glucose availability
Maintenance of vascular system
Protein breakdown
Fat breakdown
Suppression of immune and inflammatory response
CNS excitability
what occurs with increased glucose availability?
Glucose intolerance
Hyperglycemia
What occurs with maintenance of the vascular system and too much cortisol
HTN
Capillary friability
eccymoses
what occurs with that break down and too much cortisol?
Redistribution of fat
Abdomen, shoulders, face
what occurs with a suppressed immune and inflammatory response?
Impaired wound healing and immune response
Risk for infection
what do mood swings and insomnia occur from?
CNS excitability
what are common symptoms associated with Cushing syndrome?
Loss of libido
Thinning hair
Hirsutism– chest, areola, chin
thinning of extremities
Buffalo hump
Moon face
Apple shaped
Purple striae
Ekhymosis
Fragile skin
Osteoporosis
Hyperglycemia
what would be the drug therapy for a pituitary or adrenal tumor?
Surgery, radiation
t/f for Exogenesis steroid drug therapy, you would need to taper off slowly
True
Addison’s disease
Hyposecretion of adrenal, cortisol hormones
Disease of adrenal cortex
3 S’s
Salt – aldosterone
Sugar – glucose
Sex - androgen
cause of Addison’s disease
Idiopathic**
Auto immune
Pathogenesis of Addison’s disease
adrenal gland destroyed/damaged
ACTH & MSH are secreted in large amounts
early s/sx Addison’s disease
Anorexia, weight loss
Fatigue, weakness, malaise
Electrolyte in balance
Skin hyper pigmentation
Hyperaldosteronism
Sodium/water retention problems
Hyponatremia
hypotension
Decreased vascular tone, CO, circulating blood volume
Results in fluid volume deficit
hypercorticolism
No energy, weakness, fatigue
Hypoglycemia
why does a patient experience hypoglycemia?
Cortisol usually raises blood sugar, not enough in Addison’s disease
Salt craving due to
Decreased serum, sodium levels
Increased serum, potassium levels
Dehydration
unsuppressed ACTH production results in
Hyper pigmentation
Due to increased melanocyte, stimulating hormone
Addisonian crisis
Acute adrenal insufficiency
No cortisol to combat stress
t/f addisonian crisis is a medical emergency
True
causes of addisonian crisis
Sudden increase in stress with chronic condition
Sudden cessation of serum corticosteroids
Sudden loss of adrenal gland
t/f cortical steroid therapy is not a lifelong process
False, it is
pharm therapy
Dosing mimics natural release of hormones, mainly given at night
should corticosteroid therapy be abruptly stopped
Never
what should you do with the dosing of steroids with stress?
Increase the dosage
pheochromocytoma
adrenal medulla disorder
Rear tumor of adrenal medulla that produces excess catecholamines
What are catecholamines
Epinephrine
Norepinephrine
is pheochromocytoma, benign or malignant
Benign
t/f older adults are more at risk for pheochromocytoma
False, young to middle age, more at risk
pathogenesis of pheochromocytoma
SNS stimulus
Tumor cells secrete catecholamines
s/sx pheochromocytoma
headache
HTN ***
Tachycardia
Diaphoresis
why is HTN the most common symptom?
Due to the activation of alpha one receptors on blood vessels
drug therapy for pheochromocytoma
Preferred – surgery, removal of tumor
Alpha 1 adrenergic blockers maybe used
why would alpha adrenergic blockers be used?
Inoperable tumors
10 to 14 days prior to operation to Reduce risk of a cute hypertension
