dx of adrenal cortex Flashcards
1
Q
cushing syndrome
A
- excess or glucocorticoids
- sweet and hanging on to H2O
2
Q
classic s/s of cushing syndrome
A
- weight gain
- truncal obesity
- moon face
- buffalo hump
- purplish strae
3
Q
diagnostics cushing syndrome
A
- 24 hour urine for free cortisol
- dexamethasone suppression test
- plasma cortisol
- CT scan, MRI to look for tumor
- plasma ACTH levels
- CBC electrolytes
- eye exam
4
Q
tx for cushing syndrome
A
- transsphenoidal surgery: pituitary tumor
- adrenlectomy for malignant tumors
- radiation
- drugs: mitotane, ketoconazole
- gradual d/c of corticosteroids
5
Q
complications of cushing syndrome
A
- CV dz
- DM
- infx
- polycythemia
- changes in appearance: hirsutism, gynecomastia
6
Q
interventions of cushing syndrome
A
- monitor VS
- daily weights
- monitor glucose
- control HTN, hyperglycemia, hypokalemia
- high protein diet
7
Q
postop for cushing syndrome
A
- monitor for post hemorrhage (around flank)
- monitor BP, fluid balance, electrolytes
- high doses of corticosteroids
- monitor infx, I/O
- monitor urine cortisol levels
8
Q
adrenocortical insufficiency
A
-hypofunction of adrenal cortex
9
Q
primary adrenocortical insufficiency
A
addison’s disease
10
Q
secondary adrenocortical insufficiency
A
- lack of ACTH secretion
- d/t pituitary dz or suppression of the hypothalamic pituitary axis
11
Q
addison’s dz
A
- d/t autoimmune response
- adrenal tissue is destroyed by antibodies
12
Q
s/s of addison’s dz
A
- hyperpigmentation
- hypotension
- fatiguability
- decreased muscle size and tone
13
Q
diagnostics for addison’s dz
A
- ACTH stimulation test
- electrolytes, glucose, CBC, BUN/Cr
- peaked T waves
- CT scan, MRI
14
Q
tx for addison’s dz
A
- hydrocortisone (replacement tx)
- during stress: increase cortisol
- mineralcorticoid replacement
- increase salt intake
15
Q
medium stress in addison’s dz
A
- double dose
- surgery
- infection
