nats notes other half

Question 1

Primary adrenal insufficiency-

Answer 1

issue with the gland

Question 2

secondary adrenal insufficiency

Answer 2

issue stimulating the gland

Question 3

primary adrenal insufficiency results in

Answer 3

addisons

Question 4

addisons symptoms

Answer 4

chronic malaise lassitude/lethargy 
fatigue that is worsened by exertion and improved with bed rest 
weakness generalised 
anorexia 
weight loss

Question 5

signs

Answer 5

Gastrointestinal complains
Hypotension 
Electrolyte abnormalities 
Hypoglycaemia
Hyperpigmentation

Question 6

hypoglycaemia in addisons is due to

Answer 6

depleted cortisol

Question 7

hyperpigmentation in addisons is due to

Answer 7

due to increased ACTH

Question 8

causes of addisons

Answer 8

auto-immune 
infection
Infiltration
Infarction
Haemorrhage 
Adrenoleukodystrophy

Question 9

diagnosing adrenal insufficiency

Answer 9

Synacthen test

Question 10

what is Synacthen test

Answer 10

synthetic ACTH

Question 11

what is increased in addisons

Answer 11

ACTH

Question 12

where does ACTH come from

Answer 12

anterior pituitary

Question 13

Autoimmune Poly-glandular Syndromes

Answer 13

group of rare diseases characterized by autoimmune activity against more than one endocrine organ

Question 14

when is ACTH reduced

Answer 14

secondary adrenal insufficiency

Question 15

what type of APS is more common in children

Answer 15

APS type 1

Question 16

APS type 1

Answer 16

chronic mucocutaneous candidiasis
hypoparathyroidism
Addison’s disease

Question 17

APS type 2

Answer 17

Addison’s disease
autoimmune thyroid disease
diabetes mellitus

Question 18

what can adrenal crisis in addisons be precipitated by

Answer 18

infection

Question 19

main factor precipitating adrenal crisis

Answer 19

mineralocorticoid

Question 20

biggest manifestation of adrenal shock

Answer 20

hypotension

Question 21

longterm treatment of addisons

Answer 21

Hydrocortisone
Fludrocortisone
Androgen replacement
HPA axis suppression

Question 22

rules of steroids

Answer 22

never stop taking
carry card
double does in illness

Question 23

cushings syndrome

Answer 23

prolonged exposure to elevated levels of glucocorticoids

Question 24

most common cause of cushings

Answer 24

exogenous corticosteroid use

Question 25

Cushing’s disease

Answer 25

ACTH producing pituitary adenoma causing hypercortisolaemia

Question 26

ACTH dependant cushings causes

Answer 26

pituitary adenoma or ectopic ACTH production

Question 27

ACTH independant cushings causes

Answer 27

majority cause by exogenous steroids or adrenal adenomas/carcinomas

Question 28

diagnosis of cushings

Answer 28

blood abnormalities raised WBC hyperglycaemia hypokalaemic metabolic alkalosis

Question 29

humeral control of BP

Answer 29

RAAS

Question 30

naural BP regulation

Answer 30

baroreceptors

Question 31

where are the baroreceptors

Answer 31

aortic arch carotid bodies

Question 32

what happens if BP increases (neural regulation)

Answer 32

If BP increases baroreceptors stimulate nucleus of solitary tract which stimulates vagus nerve to reduce HR and reduce BP

Question 33

shocks

Answer 33

``` anaphylactic cardiogenic hypovolemic neurogenic septic ```

Question 34

cardiac output equation

Answer 34

stroke X heart rate

Question 35

pressure equation

Answer 35

flow X output

Question 36

primary problems of hypovolaemia

Answer 36

low volume | fall in cardiac output

Question 37

compensatory mechs of hypovolaemia

Answer 37

increased resistance (R), tachycardia, but cardiac output falls, hypotension

Question 38

hypovolaemis signs

Answer 38

cold, clammy, peripheries tachycardia prolonged capillary refill time empty veins

Question 39

compensation of pump failure

Answer 39

increased resistance (R), tachycardia

Question 40

clinical pump failure signs

Answer 40

cold, clammy peripheries tachycardia prolonged capillary refill time raised JVP

Question 41

vasodilation compensation

Answer 41

tachycardia, cardiac output rises

Question 42

vasodilation signs

Answer 42

warm dry peripheries tachycardia short capillary refill time BOUNDING pulse

Question 43

signs of shock

Answer 43

oliguria | altered consiousness

Question 44

intrinsic causes of pump failure

Answer 44

muscle, conduction tissue, valves

Question 45

extrinsic pump failure

Answer 45

obstruction- pulmonary embolus compression- tamponade (fluid fills the pericardium) blood supply

Question 46

tamponade

Answer 46

fluid fills the pericardium