Endocrine Emergencies

Question 1

Hyperosmolar Hyperglycemic State

Answer 1

Occurs in patients with poorly controlled or undiagnosed type II DM
Severe hyperglycemia
Hyperosmolality
RELATIVE LACK of ketonemia
Serum glucose usually > 600 mg/dL
Elevated plasma osmolality of > 315 mOsm/kg
Bicarbonate > 15
Arterial pH > 7.3

Question 2

Adrenal Cortex Zones

Answer 2

Glomerulosa: mineralocorticoids… aldosterone
Fasciculata: glucocorticoids… cortisol
Reticularis: sex hormones

Question 3

Primary Adrenal Insufficiency (addisons)

Answer 3

Failure of adrenal glands to produce essential BASAL secretion of steroids
Insidious wasting disease
bronze skin, hair loss, fatigue, weight loss
HIGH ACTH

Question 4

Adrenal Crisis

Answer 4

Failure to RESPOND to the increased demands caused by stress or SUDDEN INABILITY to secrete essential steroids
Life-threatening condition
Marked hypotension and abdominal pain

Question 5

Secondary Adrenal Insufficiency

Answer 5

Results from inadequate stimulation of adrenal cortex by ACTH (***By far the most common cause is chronic administration of exogenous steroids!)

Question 6

Symptoms that may be seen in thyroid storm NOT necessarily seen with hyperthyroidism:

Answer 6

Fever
Arrhythmia
Congestive heart failure
CNS dysfunction: Agitation, confusion, delirium, stupor, coma, seizure