Endocrinology Flashcards
what is another term for primary adrenal insufficiency
Addison’s disease
what is the lab presentation wtih primary adrenal insufficiency
decrease in cortisol
increase in ACTH
no increase in cortisol level after ACTH stimulation test
decrease in aldosterone and high plasma renin activity
what is secondary adreal insufficiency
insufficient pituitary ACTH production
what are the lab presentation of secondary adrenal insufficiency
decrease cortisol
decrease ACTH
increase in cortisol after ACTH administration but no aldosterone deficiency
what is tertiary adrenal insufficiency
insufficient CRH production
- decrease in cortisol and normal aldosterone
what is the lab presentation of tertiary adreal insufficiency
decrease cortisol
decrease ACTH
increase in cortisol after ACTH administration
ACTH levels increase after CRH injection
what is the most common cause of tertiary adrenal insufficiency
sudden withdrawal of glucocorticoid therapy or after the cure of cushings disease
what lab findings are seen with addisons
decrease sodium
decrease 8am cortisol
increase ACTH (primary)
increase potassium
low DHEA
how is addisons diagnosed
high dose cosyntropin (synthetic ACTH) stimulation test
blood/urine cortisol measured after IM injection of cosyntropin
what is the treatment of addisons
hydrocortisone/prednisone PO daily
what is the presentation of addisons crisis
hypotension and altered mental status
what is the treatment of addisons crisis
emergent IV saline
glucose
steroids
Define Cushings disease
excess cortisol
what is the presentation of cushing disease
increased cortisol
cuffalo hum
moon facies
pigmented straie
obestity
skin artrophy
HTN
weight gain
hypokalemia
how is Cushings diagnosed
low dose dexamethasone suppression test - failure to decrease cortisol level = diagnostic
what is the somogyi effect
noctural hypoglycemia followed by rebound hyperglycemia due to a surge in growth hormone
how is the somogyi effect treated
decrease nighttime NPH dose or given bedtime snack
what is the treatment of DKA
fluids (NS)
insulin administered via IV pump
what is the presentation of hyperthryoidism
heat intolerance
palpitations
sweating
weight loss
tremor
anxiety
tachycardia
what are the causes of hyperthyroidism
Graves disease
toxic adenoma
thyroiditis
pregnancy and amiodarone
what is the tx of hyperthyroidism
BB (symptomatic), methimazole/PTU, radioactive iodine, thryoidectomy
when can PTU be given during pregnancy
PTU can be given during first timester only
switch to methimazole for the remaineder of the pregnancy
what is hashimotos
hypothyroidism
what is the presentation of hypothyroidism
cold intolerance
fatigue
constipation
depression
weight gain
bradycardia
what is the lab presentation of hypothyroidism
TSH - elevated in primary disease
Low T4
