Endocrine 3

Question 1

what is the MAJOR mineralocorticoid

Answer 1

ALDOSTERONE

Question 2

what is the role of aldosterone

Answer 2

RETAIN sodium and water and LOSE potassium

Question 3

too much aldosterone results in

Answer 3

FLUID VOLUME EXCESS

Question 4

too little aldosterone results in

Answer 4

RETAIN K

FLUID VOLUME DEFICIT

Question 5

what are the sex hormones

Answer 5

testosterone and progesterone

Question 6

increase in sex hormones results in

Answer 6

acne, irregular menstruation, hirsutism

Question 7

decrease in sex hormones results in

Answer 7

decreased axillary/pubic hair, decreased libido

Question 8

4 components of Addison’s

Answer 8

1) not enough steroids
2) risk of SHOCK
3) hypercalcemia
4) hypoglycemia

Question 9

what is the main problem with Addison’s

Answer 9

adrenocortical insufficiency (not enough steroids)

Question 10

what is okay to increase in Addison’s pt

Answer 10

Salt in diet so fruit juice and broccoli are okay

Question 11

what occurs in Addison’s pt (electrolyte)

Answer 11

• lose sodium and water

- retain/increase serum K due to decreased aldosterone

Question 12

what must an Addison’s pt do daily

Answer 12

weigh themselves

Question 13

indicators of adrenal crisis

Answer 13

profound fatigue
dehydration
vascular collapse (decrease BP)
decreased Na
increased K

Question 14

s/s of addison’s

Answer 14

depression
hypoglycemia
postural hypotension
wt loss/ anorexia
weakness/fatigue
GI disturbance
tachy
bronze color

Question 15

treatment of Addison’s

Answer 15

replace both steroids (glucocorticoids and mineralocorticoids)

Question 16

glucocorticoid treatment

Answer 16

Prednisone

• give 2x a day, split dose
• 2/3 in morning and 1/3 at night

Question 17

mineralocorticoid treatment

Answer 17

Fludrocortisone

aka aldosterone

Question 18

education with Addison’s meds

Answer 18

-daily wt cheks and BP checks
-report wt gain >5 lbs
-will be on this med for rest of life
do NOT abruptly stop taking meds

Question 19

when Addison’s meds are taken…

Answer 19

glands stop producing steroids (dangerous to stop meds abruptly)
can cause an addisonian crisis

Question 20

explain an addisonian crisis

Answer 20

acute onset of hypotension
vascular collapse
x100 worse than addisons
can lead to shock (loss of volume)

Question 21

main problem with cushing’s syndrome

Answer 21

too many steroids

Question 22

what occurs in cushing’s

Answer 22

fluid volume excess (retention of Na and water)

-leads to edema

Question 23

potassium levels in cushing’s

Answer 23

decreased due to increased aldosterone

Question 24

describe steroids in relationship to Ca

Answer 24

steroids increase the uptake of Ca, excreted through GI tract

Question 25

how does body compensate for steroids increased Ca uptake

Answer 25

-body compensates by pulling Ca from bone to blood (causing osteoporosis)

Question 26

blood work on a pt with cushings would show...

Answer 26

high corticosteroid level

Question 27

s/s of cushings

Answer 27

``` hyperglycemia personality changes *moon face increased infection risk osteoporosis Na and fluid retention thin extremities GI distress thin skin bruises, petechiae obesity ```

Question 28

what is the opposite of cushings

Answer 28

addisons

Question 29

surgical treatment of cushings

Answer 29

adrenalectomy (unilateral or bilateral)

Question 30

if total adrenalectomy what is needed

Answer 30

lifetime supply of steroid (meds)

Question 31

cushings pt cannot handle _____

Answer 31

stress, needs a quiet environment

Question 32

diet for cushings

Answer 32

diet: NO extra sodium (should decrease) | - increase protein, potassium, and calcium in diet

Question 33

other treatment for cushings

Answer 33

fluid restriction (watch intake/output) stop production of ACTH (want to decrease corticosteroid secretion) get wt daily

Question 34

compare cushings and conns

Answer 34

cushings=too much of ALL steroids | conns= ONLY too much mineralocorticoid (aldosterone)

Question 35

describe what ADH does

Answer 35

``` antidiuretic HOLS fluid (just water) ```

Question 36

alcohol naturally inhibits ____

Answer 36

ADH

Question 37

describe how alcohol affects ADH

Answer 37

inhibits it so makes you pee a lot (clear, dilute) | dehydrates you-results in vasoconstriction

Question 38

what is the opposite of SIADH

Answer 38

diabetes insipidus