ENDO Flashcards
CUSHING’S Ano mataas at mababa sa cushings
⬆️ salt, sex, sugar ⬇️Ca, K, Immunity
CUSHING’S Aside from steroids and tumor as causes ano pa isang cause
LUNG CA
CUSHING’S Sx (CUSH)
- Cushion (truncal obesity, moon face, buffalo hump, Gynecomastia
- Unusual hair growth (hirsutism)
- Skin acne, purple striae, butterfly mark
- High BP+ osteoporosis + muscle weakness
CUSHING’S meds
- Mitotane
- Metyrapone
- Ketoconazole
- Levoketoconazole
- Spirinolactone
CUSHING’S Dx
1. What type of urine test
2. done at night
3. Pag binigay to tas mataas parin postive sa cushing
4. Tatlong dx na sa blood naman extraction
24H URINE CORTISOL TEST
SALIVA CORTISOL TEST
DEXAMETHASONE SUPPRESSION TEST
SERUM NA, SERUM K, FBS
CUSHING’S list K rich foods (C BROAS)
CANTALOUPE/MELON
BANANA/BROCOLLI
RAISIN
ORANGE (highest)
APPLE/AVOCADO/ASPARAGUS
STRAWBERRY/SPINACH
CUSHING’S rx for?
INFECTION
CUSHING’S * Type of isolation * Restrict __ * Diet: * Compli: * 2 surgical tx
- REVERSE ISOLATION
- NA
- ⬇️CHO & FATS ⬆️K & CHON
- DM 2 & INFECTION
- HYPOPHYSECTOMY & BILATERAL ADRENALECTOMY
CUSHING’S 3 important assessments
WEIGH DAILY
EDEMA ASSESSMENT
WOF HYPOKALEMIA SX
AKA PRIMARY ADRENAL INSUFFICIENCY
ADDISON’S DSE
ADDISON’S HALL MARK
BRONZE SKIN
ADDISON’S ano mataas at mababa in this dse
⬇️salt sex sugar ⬆️Ca K + bronze skin
ADDISON’S Sx (ADDS)
- Added tan & K
- Dec weight
- Dec hair, BP, energy
- Sodium Loss/ salt craving
ADDISON’S diet
- ⬆️CHO CHON ⬇️ K
- Inc Na on hot weather
ADDISON’S Iwa watch out
HYPERK
ADDISONIAN/ ADRENAL CRISIS/ ACUTE ADRENAL FAILURE
ADISSONIAN CRISIS bawal magbigay ng steroids if?
drop in BP 89/40 less (shock)
ADISSONIAN CRISIS sx
- Severe headache, low back pain, abd pain, leg pain
- Extreme weakness and HypoNa
ADISSONIAN CRISIS mngt
- IV fluid (shock)
- Fludrocortisone
- Hydrocortisone (po, maintenance)
- avoid infection
ADDISON’S med
ADD-sone + Kayexelate and Insulin
* Fludrocortisone (mineralocorticoid)
* Dexa, Hydrocortisone, Prednisone (glucocorticoids)
STEROIDS anong 7S tatandaan
- stress & surgery- inc the dose
- Slowly taper off
- Sugar inc
- Sepsis/ low WBC
- sight rx (cataract)
- Skinny (muscles & osteoporosis)
- Swollen (water gain)
what disorder ung ⬆️ADH but mababa sa osmolality and Na
SIADH
SIADH URINE SPECIFIC GRAVITY RESULT?
Concentrated
SIADH ⬇️Na early sx
HEADACHE
SIADH seizure early sx
HEAD AND CONFUSION (WATER INTOXICATION/CEREBRAL EDEMA)
SIADH Mngt
- 800-1k ml/ day of fluids lang per day
- Give salt
- Loop diuretics w 3% saline (hypertonic)
- Seizure precautions & IO
SIADH meds
Aquaretics/ Vasopressin 2 receptor antagonists (-vaptan)
++Urea & Demeclocycline (ADH antagonist) for chronic
Most accurate measure for fluid balance
DAILY WEIGHTS
what disorder ung ⬇️ADH but mataas sa osmolality and Na
DI
DI specific gravity
Diluted
DI compli
Hypovolemic shock
DI mga bawal
Caffeined beverages, alcohol, parsley, celery
Late sx of hypovolemic shock
ANURIA <100ml/day
Too much release of ⬆️Ca but⬇️Phosphorus
HYPERPARATHYROIDISM
HYPERPARATHYROIDISM SX
STONES=KIDNEY
MOANS= FRACTURE & BONE PAIN
GROAND= CONSTIPATION
muscle weakness, arrythmia, hypoactive DTR, altered LOC (blood bone beats)
HYPERPARATHYROIDISM Diet
Lean meats- Rich in Phosphorus
HYPERPARATHYROIDISM tx
- Morphine/demerol for bone pain
- Amiodarone for arrhythmia
- Calcitonin
- IV phosphate
- Furesomide
- Magsul
- Parathyroidectomy
⬇️Ca but ⬆️Phosphorus
HYPOPARATHYROIDISM
HYPOPARATHYROIDISM HALLMARKS and other sx
TwiTChing Spasm
* TROUSSEAU’S AND CHOVSTEK’S SX + diarrhea
* Arrythmia din
* SPASMS
* Seizure
HYPOPARATHYROIDISM Anong mineral pede caused nito
Hypomagnesemia (Ca and Mg kakampi) (Opposite sina Na and K)
HYPOPARATHYROIDISM med
- Ca gluconate, Ca carbonate, Ca lactate
- Vit D (calcitriol)
- Phenobarbital for seizure
- Teriparatide to dec phosphate inc Ca