Endocrine Flashcards
Where is the Adrenal Gland located?
- Two small pyramidal structures
- Situated at the superior pole of each kidney
What are the 3 “Zonas” of the Adrenal Gland?
- Zona glomerulosa
- Zona fasiculata
- Zona reticularis
What layer of the Adrenal gland is Aldosterone produced?
Zona Glomerulosa
What layer of the Adrenal Gland produces Cortisol and Androgens?
Zona Fasiculata and Zona Reticularis
What layer of the Adrenal Gland produces Epinephrine and Norepinephrine?
Medulla
Define Glucocorticoid?
- Any of a group of corticosteroids (e.g., hydrocortisone) that are involved in the metabolism of carbohydrates, proteins, and fats and have anti-inflammatory activity.
What is Cortisol?
- Primary glucocorticoid (produced in the Adrenal Cortex)
- Allows body to adapt to stress and contributes to maintenance of hemeostasis
What is the daily secretion of Cortisol from the Adrenal Gland/day?
20 mg/day (15-30 mg/day)
What is Aldosterone?
- Aldosterone, the main mineralocorticoid hormone, is a steroid hormone produced by the zona glomerulosa of the adrenal cortex in the adrenal gland.
- It is essential for sodium conservation in the kidney, salivary glands, sweat glands and colon.
- It plays a central role in the homeostatic regulation of blood pressure, plasma sodium (Na+), and potassium (K+) levels.
What is the recomended Hydrocortisone dosage regarding steroidl supplementation during surgery for minor surgery?
- 25 mg hydrocortisone equivalent
- Preoperatively on the day of surgery
What is the recomended Hydrocortisone dosage regarding steroidl supplementation during surgery for Moderate surgical stress?
- 50-75 mg on day of surgery and up to 1 day after
- Return to preoperative glucocorticoid dose on postoperative day 2
What is the recomended Hydrocortisone dosage regarding steroidl supplementation during surgery for Major surgical stress?
- 100-150 mg per day of hydrocoritsone equivalent given for 2 to 3 days
- After preoperative dose, 50 mg hydrocortisone IV every 8 hours after the initial dose for the first 48 to 72 hours after sugery
What are the 3 types of Adrenal Insufficiency?
Who is at risk for an adrenal crisis?
- Addison’ Disease
- Most at risk for adrenal crisis
- Consult Endocrinologist
For secondary adrenal insufficiency, can you give local anesthesia? Do you hav eto supplement?
- Normal local anesthesia
- No supplementation - maintain usual dose
What are 2 labs you can order to assess for Chronic Kidney Disease?
- BUN
- Creatinine
What is Creatinine?
What is BUN?
What is Azotemia vs Uremia?
Azotemia
- Point at which you will see abnormal lab values
Uremia:
- Point at which symptoms appear
- Uremic frosting
- Altered mental status
- Platelet disfunction
What are 3 drugs classes to avoid in a patient with Chronic Kidney Disease?
- NSAIDS
- Cephlasporins
- Aminoglycosides (nephrotoxic)
What does Erythropoietin do?
Good for treating Anemia patients
What is Dialysis?
What is Peritoneal Dialysis?
What is Hemodialysis
What is Vascular Access for a patient with ESRD?
What are some functions of the Liver?
- Carohydrate Metabolism
- Synthesis of Proteins
- Synthesis of bile acids
- Toxin Disposal
Where does Gluconeogenesis happen?
- Liver
- Gluconeogenesis from amino acids
What 2 important proteins does the Liver produce?
- Albumin
- Clotting Factors
What toxins does the Liver dispose of?
- Bilirubin
- Ammonia
- Medications
What is NASH?
What is Cirrhosis?
What labs would you run for End Stage Liver Disease?
- CBC
- Coag panel
What is a clinical sequelae of a patient with End Stage Liver Disease?
- Hemorrhage
- Platelets
- Low due to sequestration and marrows toxicity
> ________ platelet is generally safe…
50K
How many platelets are in 1 transfusion unit?
30K
What Local Anesthetics are metabolized in the liver?
- Lidocaine
- Prilocaine
- Mepivicaine (Polocaine)
- Bupivicaine (Marcaine)
- Articaine (Septocaine)
What are some Analgesics that are metabolized in the liver?
- ASA
- Acetaminophen
- Ibuprofen
- Codeine
- Meperidine (Demerol)
What are some sedatives that are metabolized in the liver?
- Diazepam (Valium)
- Barbituates
What are some Antifungals that are metabolized in the liver?
- Ketoconazole
- Fluconazole
What are some Antibiotics that are metabolized by the liver?
- Amoxicilline (Partial)
- Clindamycin
- Erythromycin
- Tetracycline
