Adrenal Gland Problems Quiz
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Questions and Answers

What is a primary cause of acute adrenal insufficiency?

  • Regular intense exercise
  • Abrupt stop of steroids (correct)
  • Continuous high-dose steroid therapy
  • Low dietary sodium intake

Which of the following interventions is important when monitoring a patient with acute adrenal insufficiency?

  • Monitor I&Os (correct)
  • Avoid all dietary changes
  • Limit fluid intake to prevent overload
  • Daily exercise regimen

What treatment is administered rapidly for acute adrenal insufficiency?

  • IV steroids, saline fluids, and sugar (correct)
  • Oral antibiotics
  • Topical corticosteroids
  • Oral antihistamines

Which dietary change should be made to manage potassium levels in a patient with acute adrenal insufficiency?

<p>Avoid potassium-rich foods (C)</p> Signup and view all the answers

What should a patient with adrenal insufficiency do in case of an emergency?

<p>Administer intramuscular glucocorticoid pens (C)</p> Signup and view all the answers

Which medication is typically used to prevent stress ulcers in patients with acute adrenal insufficiency?

<p>Famotidine (B)</p> Signup and view all the answers

What cardiovascular effect should one be cautious about when administering steroids?

<p>Hypertension and tachycardia (A)</p> Signup and view all the answers

Which vital signs monitoring frequency is appropriate for a patient with acute adrenal insufficiency?

<p>Every 1-4 hours (C)</p> Signup and view all the answers

What should be monitored for as potential signs of meningitis?

<p>Headaches and visual changes (B)</p> Signup and view all the answers

What is a recommended action to prevent complications after surgery?

<p>Sneeze with mouth open (C)</p> Signup and view all the answers

Which hormone is primarily responsible for growth in muscles and bones during adolescence?

<p>Growth hormone (A)</p> Signup and view all the answers

What is one of the key aspects of post-operative care regarding oral hygiene?

<p>Brushing teeth is to be avoided for 10 days (D)</p> Signup and view all the answers

How should patients after surgery manage increased intracranial pressure (ICP)?

<p>Rest frequently and avoid certain activities (B)</p> Signup and view all the answers

What is a normal post-operative observation regarding nasal discharge?

<p>Blood tinged mucus is normal (D)</p> Signup and view all the answers

What should patients be educated about regarding lifelong hormone therapy?

<p>It should be continued indefinitely (C)</p> Signup and view all the answers

What role does IGF-1 play in the body concerning growth?

<p>It is responsible for many growth-promoting effects of growth hormone (C)</p> Signup and view all the answers

What condition is characterized by decreased bone density, increased visceral fat mass, and increased cholesterol due to low IGF-1 levels?

<p>Hypopituitarism (C)</p> Signup and view all the answers

Which symptom is NOT associated with hyperprolactinemia?

<p>Increased muscle mass (A)</p> Signup and view all the answers

What is a common treatment option for acromegaly?

<p>Somatostatin analogs like Octreotide (B)</p> Signup and view all the answers

Which of the following is NOT a symptom of acromegaly?

<p>Hypoglycemia (C)</p> Signup and view all the answers

What effect does Human Growth Hormone (HGH) have when administered?

<p>Improved muscle mass (C)</p> Signup and view all the answers

In the context of hypopituitarism, what effect is NOT observed in children?

<p>Increased head circumference (A)</p> Signup and view all the answers

What hormone can block prolactin production?

<p>Dopamine (D)</p> Signup and view all the answers

Which hormone levels are typically used to diagnose GH-related disorders?

<p>Insulin-like growth factor 1 (IGF-1) (A)</p> Signup and view all the answers

Which of the following is a side effect of Human Growth Hormone (HGH) therapy?

<p>Hyperglycemia (B)</p> Signup and view all the answers

What physical change is associated with gigantism in children?

<p>Rapid and excessive height growth (C)</p> Signup and view all the answers

What is a critical precaution to take after a thyroidectomy?

<p>Keep the neck in a neutral position (C)</p> Signup and view all the answers

What is the most critical complication following a thyroidectomy?

<p>Thyroid storm (A)</p> Signup and view all the answers

Which medication is considered first line for treating thyroid storm?

<p>PTU via IV (D)</p> Signup and view all the answers

What should be monitored closely postoperatively for signs of complications?

<p>Neck dressing for bleeding (C)</p> Signup and view all the answers

What lifestyle change is necessary after a total thyroidectomy?

<p>Lifelong hormone replacement therapy (C)</p> Signup and view all the answers

Which symptom is indicative of potential tracheal compression after a thyroidectomy?

<p>Difficulty swallowing (A)</p> Signup and view all the answers

What should be done immediately if signs of a thyroid storm appear?

<p>Use cooling measures and supportive care (A)</p> Signup and view all the answers

Which of the following should NOT be used in cooling measures for a patient in thyroid storm?

<p>NSAIDs (C)</p> Signup and view all the answers

Which of the following medications is considered the first-line treatment for hyperthyroidism?

<p>Methimazole (A)</p> Signup and view all the answers

What is a common symptom associated with Graves disease?

<p>Exophthalmos (A)</p> Signup and view all the answers

What is the primary function of T3 and T4 hormones in the body?

<p>Stimulate bone resorption (A)</p> Signup and view all the answers

Which hormone is primarily responsible for stimulating the thyroid gland?

<p>Thyroid stimulating hormone (TSH) (B)</p> Signup and view all the answers

What is the role of potassium iodide (SSKI) in the treatment of hyperthyroidism?

<p>To suppress thyroid function prior to surgery (D)</p> Signup and view all the answers

Which condition could lead to secondary hyperthyroidism?

<p>Pituitary tumor (D)</p> Signup and view all the answers

What is a key distinguishing feature of hyperthyroidism related to metabolic changes?

<p>Increased energy and anxiety (B)</p> Signup and view all the answers

Which of the following is a common assessment finding in a patient with hyperthyroidism?

<p>Increased heart rate and blood pressure (C)</p> Signup and view all the answers

How long should anti-thyroid medications generally be taken before tapering off?

<p>1-1.5 years (D)</p> Signup and view all the answers

Which of the following is NOT a side effect of Methimazole?

<p>Increased weight (A)</p> Signup and view all the answers

Which medication is known as 'Puts Thyroid Underground'?

<p>Propylthiouracil (PTU) (D)</p> Signup and view all the answers

What is the primary purpose of radioactive iodine therapy in treating hyperthyroidism?

<p>To destroy thyroid tissue (B)</p> Signup and view all the answers

Which of the following dietary recommendations is suggested for patients with hyperthyroidism?

<p>High in calories, protein, and carbohydrates (D)</p> Signup and view all the answers

What is the primary cause of Cushing Disease?

<p>Excess cortisol produced by the body (D)</p> Signup and view all the answers

Which condition is most commonly associated with exogenous Cushing Syndrome?

<p>Asthma treatment (A)</p> Signup and view all the answers

What would be an expected result in an ACTH plasma level test for a patient with Cushing Disease?

<p>Decreased levels (C)</p> Signup and view all the answers

What is a common psychosocial assessment observation in Cushing Disease patients?

<p>Irregular sleeping patterns (A)</p> Signup and view all the answers

In the treatment of Cushing Syndrome due to exogenous sources, what intervention is crucial?

<p>Taper down steroid medication (D)</p> Signup and view all the answers

What surgical procedure is typically performed for hyperaldosteronism?

<p>Adrenalectomy (D)</p> Signup and view all the answers

What assessment finding is expected in a patient with hypokalemia related to hyperaldosteronism?

<p>Muscle cramps (B)</p> Signup and view all the answers

Which medication is commonly used to treat central Diabetes Insipidus?

<p>Desmopressin acetate (C)</p> Signup and view all the answers

What is a distinguishing feature of Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?

<p>Hyponatremia (B)</p> Signup and view all the answers

What is a primary symptom of diabetes insipidus related to low ADH levels?

<p>Excessive thirst (B)</p> Signup and view all the answers

Which of the following best describes hypopituitarism?

<p>Failure of production of one or more hormones (B)</p> Signup and view all the answers

What is a critical assessment finding for a patient experiencing adrenal crisis post adrenalectomy?

<p>Increased heart rate (B)</p> Signup and view all the answers

In the context of Cushing's Disease, easy bruising is likely due to which physiological change?

<p>Changes in skin integrity (D)</p> Signup and view all the answers

Flashcards

Acute Adrenal Insufficiency

A medical condition where the body cannot produce enough cortisol and aldosterone, often due to stress, abrupt steroid cessation, or severe drops in blood pressure or sugar.

Causes of Acute Adrenal Insufficiency

High stress, abrupt steroid withdrawal, hypotension (low blood pressure), and low blood sugar.

Treatment for Acute Adrenal Insufficiency

Rapid intravenous administration of steroids, fluids (saline), and sugar.

Monitoring for Acute Adrenal Insufficiency

Vital signs, EKG monitoring for arrhythmias, I&O (input and output), daily weights, and patient monitoring of lab values. Slow position changes.

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Arrhythmia Management

If arrhythmias develop, administer intravenous glucose and insulin to regulate potassium levels. Consider K+ wasting diuretics and avoid potassium-rich foods.

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Nursing Education: Adrenal Insufficiency

Patients need to wear medical alert bracelets; the condition is manageable, but not curable; they may require injectable steroids for emergencies, along with specific medication timing based on their bodies' daily rhythms.

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Home Steroid Use

Patients need to administer the correct form of steroids at the correct times, either with or without food, understanding that too much can be harmful. Patients should have a good understanding of risks, side effects and how the dosages are aligned to their bodies' daily regulations.

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Adrenal Hyperfunction

Conditions like Cushing's Syndrome involve excess cortisol production and require diagnosis and treatment through specialized means.

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Meningitis Signs

Symptoms like headache, light sensitivity, nausea, vomiting, halo sign, and visual changes can indicate meningitis.

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Post-Op Nasal Care

After surgery, expect blood-tinged mucus. Contact the doctor if bright red blood or excessive clear fluid appears.

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What does GH affect?

Growth hormone primarily affects bones and muscles, especially during adolescence.

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What does GH trigger?

GH activates IGF-1 (insulin-like growth factor), which is responsible for many of its effects.

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GH and Cell Lifespan

Growth hormone inhibits cell death, extending their lifespan.

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GH's Overall Effect

Growth hormone creates a growth-promoting environment in the body, increasing tissue size and lifespan.

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Hormone Replacement Therapy

Patients need lifelong replacement therapy to manage the missing hormone after surgery.

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Actions to Avoid After Surgery

Patients need to avoid activities that increase intracranial pressure, such as lifting heavy objects or straining while sneezing.

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GH's Role in Fat Breakdown

Growth hormone (GH) promotes the breakdown of fats and mobilizes fatty acids from fat storage, helping to reduce lipid levels in the bloodstream.

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Growth Hormone Deficiency (Hypo)

A condition where the body doesn't produce enough growth hormone, leading to issues like decreased bone density, muscle mass, and increased visceral fat mass.

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Growth Hormone Deficiency in Children

Low GH in children can cause slow height growth but doesn't affect their intelligence. Other symptoms include hypoglycemia and pituitary dwarfism.

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Growth Hormone Excess (Hyper)

A condition where the body produces too much growth hormone, leading to excessive growth in children (gigantism) and adults (acromegaly).

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Acromegaly

A condition caused by excess growth hormone in adults, leading to enlarged hands, feet, lips, nose, and other features.

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Prolactin Deficiency (Hypo)

A condition where the body produces too little prolactin, potentially leading to insufficient milk production after childbirth.

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Prolactin Excess (Hyper)

A condition where the body produces too much prolactin, leading to symptoms like decreased libido, impotence, infertility, and galactorrhea.

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Octreotide (Sandostatin)

A somatostatin analog used to treat acromegaly by reducing growth hormone production.

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Pegivsomant (Somavert)

A growth hormone receptor blocker used to treat acromegaly by preventing growth hormone from binding to its receptors.

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Surgery for Gigantism

The most common treatment option for gigantism, aiming to remove or reduce the source of excess growth hormone.

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Cushing Syndrome (Exogenous)

A syndrome caused by long-term high-dose steroid use, leading to cortisol excess.

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Cushing Disease (Endogenous)

A disease caused by an excess of ACTH, leading to cortisol excess.

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Risk Factor (Cushing Disease)

Females are more commonly affected than males.

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Cushing Disease Assessment (History)

Evaluating appetite changes, weight gain patterns, sleep disturbances, or easy bruising for symptoms.

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Hyperaldosteronism (Primary Conn's Syndrome)

A condition characterized by high aldosterone levels stemming from adrenal tumor.

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Hypokalemia

Low potassium levels in the blood.

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Hypernatremia

High sodium levels in the blood.

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Diabetes Insipidus (DI) Central

Central DI arises from issues in ADH production, transport, or release.

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Diabetes Insipidus (DI) Nephrogenic

Nephrogenic DI stems from the kidney's poor response to ADH.

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SIADH (Syndrome of Inappropriate ADH)

SIADH is a disorder where the body produces too much ADH.

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Post-hypophysectomy Care

Post-op care after pituitary surgery focusing on fluid balance, surgical site, and seizure precautions.

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Hyperaldosteronism (Secondary)

High aldosterone due to high plasma renin, often from kidney malfunction.

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DI Treatment

Treatment for Diabetes Insipidus (DI) involves maintaining fluid balance and administering vasopressin analogs.

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SIADH Treatment

Treating SIADH focuses on fluid restriction, sodium replacement, and management to prevent complications.

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Hypopituitarism

Low function or secretion of anterior pituitary gland hormones.

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Thyroidectomy Pre-Op

Preparing the patient for thyroid surgery involves ensuring normal thyroid function. This includes using antithyroid medications to control overactive thyroid and radioactive iodine treatment to reduce thyroid size.

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Thyroidectomy Post-Op

After thyroid surgery, immediate care focuses on airway management, monitoring for complications like bleeding, infection, and hypocalcemia. The patient's neck is kept in a neutral position to minimize pressure on the trachea.

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Tracheal Compression

After thyroid surgery, monitor for signs of tracheal compression such as difficulty breathing, stridor (high-pitched breathing), and voice changes. These symptoms require immediate medical attention.

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Hypocalcemia after Thyroidectomy

After thyroid surgery, monitor patients for low calcium levels. Symptoms of hypocalcemia include muscle cramps, tingling, and seizures.

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Thyroid Storm

Thyroid storm is a life-threatening condition characterized by a rapid escalation of hyperthyroid symptoms. Symptoms include high fever, rapid heart rate, and shortness of breath.

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Thyroid Storm Treatment (1st Line)

First-line treatment for thyroid storm includes medications to inhibit thyroid hormone production: propylthiouracil (PTU) intravenously, potassium iodine solution, beta-blockers to control heart rate, and corticosteroids to inhibit T4 conversion to T3.

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Thyroid Storm Treatment (Supportive)

Supportive care in thyroid storm involves managing airway and oxygenation, hydrating the patient, and monitoring vital signs. Comfort measures include electrolyte correction and potential ventilation support if breathing becomes difficult.

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Lifelong Hormone Replacement

If a total thyroidectomy is performed, the patient will require lifelong hormone replacement therapy to regulate thyroid function. This therapy involves taking synthetic thyroid hormone.

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Hyperthyroidism

A condition where the thyroid gland produces too much thyroid hormone (T3 & T4), leading to an accelerated metabolism and a range of symptoms.

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Graves' Disease

The most common cause of primary hyperthyroidism; an autoimmune disorder where the body attacks the thyroid gland causing overproduction of thyroid hormone.

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Toxic Nodular Goiter

A condition where thyroid follicles independently overproduce thyroid hormone, often occurring in individuals over 40.

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Thyroiditis

Inflammation or damage to the thyroid gland, leading to temporary hyperthyroidism.

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Exogenous Hyperthyroidism

A condition where hyperthyroidism is caused by external factors, such as too much thyroid hormone medication or certain drugs.

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Primary Hyperthyroidism

Hyperthyroidism caused by a problem within the thyroid gland, typically due to Graves' disease, toxic nodular goiter, or thyroiditis.

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Secondary Hyperthyroidism

Hyperthyroidism caused by problems outside of the thyroid gland, such as a pituitary tumor or excessive thyroid hormone intake.

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Hyperthyroidism Assessment

Assessing for symptoms like increased heart rate, high blood pressure, nervousness, weight loss, increased appetite, heat intolerance, smooth skin, and increased libido.

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Hyperthyroidism Diagnostics

Diagnostic tests include measuring T3, T4, and TSH levels, and performing radioactive iodine uptake tests, thyroid scans, ultrasounds, and ECGs.

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Graves' Disease Signs

Common signs include protruding eyeballs (exophthalmos) and goiter (enlarged thyroid gland).

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Methimazole

First-line medication for hyperthyroidism, reducing thyroid hormone synthesis.

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Propylthiouracil (PTU)

An alternative medication for hyperthyroidism, taken three times a day to reduce thyroid hormone synthesis.

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Potassium Iodide (SSKI)

Medication used to suppress thyroid hormone production before thyroid surgery.

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Beta Blockers (Propranolol)

Medications used to control heart rate and other cardiac symptoms of hyperthyroidism.

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Radioactive Iodine Therapy

A treatment option for hyperthyroidism where radioactive iodine destroys the thyroid gland.

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Study Notes

Adrenal Gland Problems

  • Adrenal glands have two parts: medulla (inner) and cortex (outer)
  • Medulla produces catecholamines (epinephrine, norepinephrine)
  • Cortex produces three main types of hormones:
    • Mineralocorticoids (e.g., aldosterone): regulate fluid volume, sodium reabsorption, and potassium excretion
    • Glucocorticoids (e.g., cortisol): regulate blood glucose, inflammatory responses
    • Androgens: responsible for sex characteristics

Adrenal Cortex: Mineralocorticoids (Aldosterone)

  • Regulates extracellular fluid volume
  • Causes sodium reabsorption and water reabsorption
  • Causes potassium loss/excretion

Adrenal Cortex: Glucocorticoids (Cortisol)

  • Secreted in response to the release of corticotropin releasing hormone (CRH) from the hypothalamus
  • Increases blood glucose levels due to gluconeogenesis in the liver
  • Regulates blood pressure by causing vasoconstriction and increasing glomerular filtration rate
  • Influences emotional stability and alertness

Adrenal Cortex: Sex Hormones

  • Androgens: involved in male and female traits, essential for puberty
  • Adrenal medulla is center of adrenal gland, responsible for the "fight or flight" response
    • Norepinephrine
    • Epinephrine

Adrenal Dysfunction: Hypofunction

  • Inadequate secretion of hormones from the hypothalamus and anterior pituitary
  • Adrenal cortex is affected, leading to a decrease in glucocorticoids and mineralocorticoids
  • Adrenalectomy is the surgical removal of the adrenal gland(s)

Adrenal Dysfunction: Hyperfunction

  • (Conn's syndrome): excess aldosterone secretion
  • Most common cause is an adrenal adenoma (benign tumor)
  • Also caused by chronic kidney disease (CKD) and a tumor secreting renin, which triggers aldosterone production
  • Clinical manifestations:
    • Hypernatremia
    • Hypokalemia

Cushing's Disease

  • Too much cortisol, often due to a pituitary tumor secreting ACTH (most common cause)
  • Risks factors: 25-40 years old, females 5 times more likely
  • Symptoms:
    • Increased appetite
    • Weight gain (central obesity)
    • Changes in sleep patterns
    • Easy bruising
  • Assessment:
    • History questioning appetite changes, sleep problems, bruising tendencies
    • Physical exam: looking for weight gain and central obesity
  • Diagnosis:
    • Blood tests to look for cortisol levels
    • Imaging studies like CT/MRI

Addison's Disease

  • Chronic condition, often autoimmune, leading to insufficient cortisol and aldosterone production
  • Risk factors: most commonly autoimmune, TB, HIV are additional causes
  • Symptoms:
    • Weight loss
    • Fatigue
    • Increased craving for salt
    • Low blood pressure
    • Muscle weakness
    • Low blood sugar
    • Abdominal pain

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Unit 1: Care of Patients with Adrenal Gland Problems PDF

Description

Test your knowledge on adrenal gland functions, focusing on the roles of the medulla and cortex, as well as the hormones produced, such as aldosterone and cortisol. This quiz covers the regulation of fluid volume, blood glucose levels, and emotional stability linked to adrenal hormones.

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