Disease of the Adrenal and Pituitary Glands Flashcards
What is addison’s disease?
Adrenal insufficiency–most commonly immune disease–but can be from tuberculosis
Adrenal crisis is caused by what?
infection or stress
Primary adrenal failure is lack of what?
corticosteriods produced by the adrenal gland
Secondary adrenal failure is lack of what?
ACTH produced by the pituitary
What are some symptoms of adrenal failure?
anorexia, weight loss, nausea, myalgias, orthostatic hypotension, hyperpigmentation (weird places like gums) (in primary)
What are the symptoms of addisonian crisis?
hypotension, abdominal pain, vomiting, diarrhea, altered mental status
What do labs show in addisonian crisis?
hyperkalemia, hyponatremia, hypoglycemia, hypercalcemia, low BUN, low morning cortisol, high ACTH
What is the cosytropin test?
give cosytropin and see if the cortisol rises (if it doesn’t think addisons)
What is the treatment for addisons?
hydrocortisone or prednisone
What is the treatment for addisonian crisis?
IV saline, glucose and glucocorticoids
What is cushing’s disease?
too much cortisol
What are some causes of cushing’s disease?
ACTH secreting pituitary adenoma, adrenal tumor, small cell lung cancer
What are the clinical features of cushings?
obesity, hypertension, increased thirst, proximal muscle weakness, pigmented striae, impaired wound healing
What labs will you see for cushings?
high urine cortisol, hypercalcemia, hypokalemia
What are two tests you can do if you have high cortisol?
MRI to look for pituitary tumor and dexamethasone suppression test
What is the treatment for cushings disease from a pituitary tumor?
tumor resection–after resection will need to replace cortisol
What is acromegaly/gigantism?
excess growth hormone due to pituitary adenoma or sporatic
What labs should you get if you suspect acromegaly?
MRI to look for pituitary tumor, prolactin, growth hormone
Treatment for acromegaly?
adenoma resection or somatostatin if refractory or can’t do resection
What causes pituitary dwarfism?
lack of growth hormone
What are signs of dwarfism?
small stature, fall off growth curve, but proportionate body
What is the treatment for dwarfism?
growth hormone replacement
What is central diabetes insipidus?
ADH not produced in the brain
What are the signs of central diabetes insipidus?
polyuria, polydipsia, sometimes even enuresis
How can you diagnose central diabetes insipidus?
vasopressin challenge test–will retain water
What is the treatment for diabetes insipidus?
desmopressin acetate
