Podcast
Questions and Answers
Which group had the highest death rate in the study?
Which group had the highest death rate in the study?
- Subphysiologic replacement group (correct)
- Supraphysiologic replacement group
- Physiologic replacement group
- Sham-operated control group
What was the cause of death in the subphysiologic replacement group?
What was the cause of death in the subphysiologic replacement group?
- Tachycardia
- Severe hypotension (correct)
- Hypovolemia
- Severe congestive heart failure
What was the effect of glucocorticoids and catecholamines on cardiac contractility and vascular tone?
What was the effect of glucocorticoids and catecholamines on cardiac contractility and vascular tone?
- No effect on cardiac contractility and vascular tone
- Increased cardiac contractility and vascular tone (correct)
- Unpredictable effects on cardiac contractility and vascular tone
- Decreased cardiac contractility and vascular tone
What was the capacity for wound healing in all treatment groups?
What was the capacity for wound healing in all treatment groups?
What did the study confirm about inadequate corticosteroid coverage?
What did the study confirm about inadequate corticosteroid coverage?
What did the Cochrane Systemic Review conclude about the use of supplemental perioperative steroids for patients with adrenal insufficiency during surgery?
What did the Cochrane Systemic Review conclude about the use of supplemental perioperative steroids for patients with adrenal insufficiency during surgery?
What is a sensitive test of pituitary-adrenal competence?
What is a sensitive test of pituitary-adrenal competence?
What increase in plasma cortisol indicates normal pituitary-adrenal responsiveness in the synthetic ACTH test?
What increase in plasma cortisol indicates normal pituitary-adrenal responsiveness in the synthetic ACTH test?
What is the daily secretion range of cortisol by the adrenal glands under perioperative conditions?
What is the daily secretion range of cortisol by the adrenal glands under perioperative conditions?
What was the mean maximal concentration of cortisol in plasma during major surgery?
What was the mean maximal concentration of cortisol in plasma during major surgery?
Which of the following statements is true about perioperative stress and corticoid supplementation?
Which of the following statements is true about perioperative stress and corticoid supplementation?
What is the main cause of perioperative cardiovascular problems in patients with suppressed adrenal function?
What is the main cause of perioperative cardiovascular problems in patients with suppressed adrenal function?
Which of the following is true about glucocorticoid or mineralocorticoid deficiency in patients taking steroids on a long-term basis?
Which of the following is true about glucocorticoid or mineralocorticoid deficiency in patients taking steroids on a long-term basis?
What is the risk of giving patients steroid coverage equivalent to 100 mg of hydrocortisone perioperatively?
What is the risk of giving patients steroid coverage equivalent to 100 mg of hydrocortisone perioperatively?
What does the study on glucocorticoid replacement in nonhuman primates reveal about inadequate perioperative corticosteroid replacement?
What does the study on glucocorticoid replacement in nonhuman primates reveal about inadequate perioperative corticosteroid replacement?
What were the doses of cortisol given to the adrenalectomized primates and sham-operated controls in the study?
What were the doses of cortisol given to the adrenalectomized primates and sham-operated controls in the study?
What was the duration of steroid administration in the study on glucocorticoid replacement in nonhuman primates?
What was the duration of steroid administration in the study on glucocorticoid replacement in nonhuman primates?
What procedure did the primates undergo in the study on glucocorticoid replacement?
What procedure did the primates undergo in the study on glucocorticoid replacement?
What was the outcome for the group given subphysiologic doses of steroid perioperatively in the study?
What was the outcome for the group given subphysiologic doses of steroid perioperatively in the study?
What is the main factor that delays the usual intraoperative glucocorticoid surge to the postoperative period?
What is the main factor that delays the usual intraoperative glucocorticoid surge to the postoperative period?
Which of the following is the maximum amount of glucocorticoid that is usually intravenously administered in response to maximal stress?
Which of the following is the maximum amount of glucocorticoid that is usually intravenously administered in response to maximal stress?
For minor surgical procedures, how much hydrocortisone is usually intravenously given per day?
For minor surgical procedures, how much hydrocortisone is usually intravenously given per day?
For major surgical procedures, how often is hydrocortisone usually given intravenously?
For major surgical procedures, how often is hydrocortisone usually given intravenously?
What are the risks of perioperative steroid supplementation?
What are the risks of perioperative steroid supplementation?
What is the effect of short-term perioperative supplementation with glucocorticoids on wound healing?
What is the effect of short-term perioperative supplementation with glucocorticoids on wound healing?
Is there an increased risk of serious infections with long-term use of steroids alone?
Is there an increased risk of serious infections with long-term use of steroids alone?
What is the effect of aging on adrenal cortex function in older adults?
What is the effect of aging on adrenal cortex function in older adults?
How does aging affect the ability to metabolize and excrete glucocorticoids?
How does aging affect the ability to metabolize and excrete glucocorticoids?
What is the most common cause of spontaneous Cushing disease in patients older than 60 years?
What is the most common cause of spontaneous Cushing disease in patients older than 60 years?
Is the rate of cortisol secretion slower in older adults?
Is the rate of cortisol secretion slower in older adults?
