Endocrine Diseases Part 2

Question 1

What are symptoms of hypoparathyroidism? (2)

Answer 1

muscle and abdominal cramping

paresthesia

Question 2

What is the treatment and perioperative treatment for hypoparathyroidism?

Answer 2

give calcium

caution of low Ca when giving blood products

Question 3

What condition results in hypoplasia/aplasia of parathyroid and thymus?

Answer 3

DiGeorge Syndrome (congenital thymic hypoplasia)

Question 4

What is the thymus gland responsible for?

Answer 4

immunity

Question 5

What are perioperative considerations for pts with DiGeorge Syndrome?

Answer 5

micrognathia–airway issues

Question 6

Adrenal cortex is responsible for producing what? (2)

Answer 6

glucocorticoids (cortisol)

minerocorticoids (aldosterone)

Question 7

Adrenal medulla is responsible for producing what?

Answer 7

catecholamines: EPI, NOREPI, Dopamine

Question 8

KNOW

Glucocorticoids ____ blood sugar levels.

Answer 8

increase

Question 9

KNOW

Aldosterone (ADH) does what 2 things?

Answer 9

increase water retention

secrete potassium

Question 10

What condition results from excessive cortisol?

Answer 10

Cushing’s Syndrome

Question 11

What are the symptoms of Cushing’s Syndrome? (4)

Answer 11

obesity

hypertension

muscle wasting and weakness

glucose intolerance

Question 12

What condition is caused from abnormal ACT (adrenocorticotrophic) hormone?

Answer 12

Cushing’s syndrome

Question 13

What is the treatment for Cushing’s Syndrome?

Answer 13

transsphenoidal resection (if microadenoma is the cause)

Question 14

What conditions do Cushing’s Syndrome patients have? (2)

Answer 14

tend to be volume overloaded

hypokalemic (cortisol acts like aldosterone)

Question 15

What condition is caused by excessive secretion of aldosterone?

Answer 15

Conn’s Syndrome

Question 16

What are the symptoms of Conn Syndrome?(5)

HHHMM

Answer 16

headache

muscle cramps

metabolic alkalosis

HTN

hypokalemia

Question 17

Conn Syndrome is _______.

Answer 17

hyperaldosteronism

Question 18

Pathophysiology includes:

congenital deficiency of aldosterone synthase, hyporeninemia, unilateral adrenalectomy

Answer 18

hypoaldosteronism

Question 19

What is Addison’s Disease? (2 points)

Answer 19

Adrenal glands do not produce enough hormones

Decreased cortisol and aldosterone

Question 20

What are the symptoms of Addison’s Disease? (5)

HHHHe was very tired…

Answer 20

hypotension

hyponatremia

hypovolemia

hyperkalemia

fatigue

Question 21

Steroids like prednisone and decadron will increase the production of ACTH. True or false?

Answer 21

false

decrease

Question 22

What is the treatment for Addison’s Disease?

Answer 22

Give steroids

Question 23

What are perioperative considerations of ACTH deficient patients? (2)

Answer 23

Give anxiety meds because stress brings out symptoms!

DO NOT give etomidate because it suppresses adrenal gland even more.

Question 24

What are the symptoms of hypoaldosteronism? (2)

Answer 24

hyperkalemia without renal insufficiency

hyperchloremic metabolic acidosis

Question 25

What condition results from a catecholamine-secreting tumor of the adrenal medulla?

Answer 25

Pheochromocytoma

Question 26

What are the symptoms of pheochromocytoma? (4)

Answer 26

sudden onset of malignant hypertension

cardiac dysrhythmias

headache

perspiration

Question 27

What medication do you give for hypoaldosteronism?

Answer 27

fludrocortisone

Question 28

What are perioperative considerations for pheochromocytoma? (3)

Answer 28

place patient on alpha-blockers before surgery

premedicate A LOT with versed, fentanyl

hemodynamic instability will be an issue

Question 29

What condition is due to excessive growth hormone?

Answer 29

acromegaly

Question 30

What are perioperative considerations for acromegaly pts?

Answer 30

airway management due to large mandible, large tongue, and small trachea