Flash conditions Flashcards
Primary adrenal insufficiency is what condition?
Addison’s disease
What is addisonian crisis?
Adrenal crisis is caused by a deficiency of cortisol resulting from Addison’s disease, congenital adrenal hyperplasia (CAH), corticosteroid biosynthetic enzyme defects or pituitary disorders (such as Sheehan’s syndrome, pituitary adenoma,
can cause syncope, vomiting, convulsions, severe lethargy
they have addisions already but a period of stress (i.e. infection) can push them into crisis.
Wiki - all signs present in adrenal crisis!! high k+ etc
Cushings disease is what?
Cause?
excess cortisol
caused by pitiutary adenoma?
Xanthochromia is usually pathognomonic of what in EMQs?
SAH - subarachnoid haem
Pituitary apoplexy is what?
Has bitemporal hemianopia which has been worsening..this should spark thoughts of a growing pituitary adenoma. But then she presents with an acute change.
With a tumour a sudden change is usually vascular.. in this case the patient is suffering pituitary apoplexy whereby her enlarging pituitary tumour has undergone haemorrhage.
This has basically wiped out pituitary function in a moment which explains her cardiovascular collapse and immensely painful headache.
In fact apoplexy can present just like a sub-arachnoid haemorrhage in patients with known adenomas.
What is nelson’s syndrome?
Nelson’s syndrome is also referred to as post adrenalectomy syndrome
Nelson’s syndrome is a rare disorder and occurs in patients who have had both adrenal glands removed owing to Cushing’s syndrome
they become cushingoid again due to microadenoma’s - ectopic acth production. they have vision disturbances too.
even high dose dexamethasone does not suppress the cortisol production - makes it clear that the tumour is not in the pituitary
SIADH characteristics?
hyponatraemic with concentrated urine (high osmolality i.e. 600).
His urine is inappropriately concentrated though they have hyponatraemia. This is caused by excessive production of ADH.
Liddles syndrome characteristics?
treatment?
Liddles is an autosomal dominant condition hence the strong family history.
The biochemical picture of hypernatraemia and hypokalaemia mimicks that of hyperaldosteronism,
they come in hypertensive
give them Amiloride or Triamterene in conjucntion with a low sodium diet.
Troussaeu’s sign is what?
basically in hypocalcaemia there is carpo-pedal spasm when blood pressure cuff is inflated to above systolic pressure.
common in conn’s as hyperaldosteronism can cause hypocalcaemia
Dumping syndrome?
Dumping syndrome occurs when food, emoves too quickly from the stomach to the duodenum.
This condition is also called rapid gastric emptying.
It is mostly associated with conditions following gastric or esophageal surgery, though it can also arise secondary to diabetes or to the use of certain medications; it is caused by an absent or insufficiently functioning pyloric sphincter.
nausea, vomiting, weakness - others on wiki
waterhouse friedrechsen
the one thats like meningitis but not meningitis.
cause by neisseria meningitis. causes septicaemia which causes adrenal apoplecy - haemorrhae usually bilaaterally. adrenal insufficiency
macula followed by purpuric rash. photophobia. kernigs positive
Man with LV failure and impaired BMs, what drug should and shouldnt be given?
give - ACE inhibitor like captopril, mainly for for the lvh in abscence of AF.
Dont give thiazide diuretic like bendroflumethiazide due to risk of diabetes
ecg finding of hypokalameia?
o Cardiac arrhythmias (ECG = ST depression, flat T-waves, U waves)
aetiology of carcinoid?
neuroendocrine tumour based in anywhere - most commonly in appendix but symptomatic when there is liver mets.
secretes serotonin, histamine, and kinins into blood
presentation of carcinoid?
Commonly presents with flushing (due to vasodilation) and diarrhoea (inc GI motility) - ongoing years before presentation.
itching (histamine)
Other clinical features include wheeze (bronchoconstriction) + SOB
palpitations, telangiectasia, and abdominal pain.
