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IOS 9 Exam 4

Disorders of the Adrenal Gland

QuestionAnswer
The Hypothalamus Gland releases Corticotropin releasing hormone
Anterior pitutary releases ACTH
Adrenal Gland releases Cortisol form the zona fasiculata (fat and CHO and Protein metabolism)
Symptoms related with Cushings syndrome Obesity, HTN, facial plethora, Glucose intolerance *Hyperglycemia
Etiologies of Cushings Cancer and Drug inducedDX of Cushings Midnight plasma cortisol>7,5 mcg.dL or Dexamethasome suppression test 1g to see if elevation and feedback occurs
Treatment of Cushings Surgery or Metyrapone, Cyproheptadine, ketoconazole
Adrenal insufficiency Primary-symptoms Hyperpigmentation, hyperkalemia, associated iwth autoimmune disease (elevated ACTH stimulation on test
Adrenal insufficiency Secondary presentation Aldosterone function intact, normal to low ACTH stimulation test- caused by long term corticosteroid administration (atrophy of gland)
Common symptoms of Both Primary and secondary adrenal insufficiency WEakness, weight loss, hypotension, GI upset, and postural dizziness
Diagnosis of adrenal insufficiency Rapid cosyntropin (synthetic ACTH) if Level 400-2000 primary, 0-50 secondary
Acute adrenal insufficiency EARLY symptoms Myalgias, maliase, anorexia, weakness, and weight los
Acute adrenal insufficiency LATE symptoms Vomiting, fever, hypotension, hyponatremia, hypoglycemia, hypercalcemia
Treatment of acute adrenal insfficiency IV hydrocortisone 100mg bolus then 100-200mg infusion q6-8hrs, fluid replacement D5/NS and if hyperkalemia Fludrocortisone (Flrinef at 0.1mg PO QD
Created by: liza001
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