Firecracker VI - Adrenals Flashcards
1) Adrenal atrophy or AI destruction
2) Granulomatous infection (TB)
3) Infarction of the adrenal gland
4) HIV
5) Waterhouse-Friderichsen syndrome
6) DIC
6 causes of Addison’s disease
- hyponatremic volume contraction,
- hyperkalemia,
- constipation,
- diarrhea,
- fatigue and
- skin hyperpigmentation.
Addison’s disease symptoms
Why do you get hyperpigmentation with Addison’s?
Melanocyte-stimulating hormone MSH shares the same precursor molecule as ACTH
What is Addison’s dz?
(primary adrenocortical insufficiency - absence of hormone production in all three cortical divisions, primary deficiency of aldo and cortisol production)
Why do people with Addison’s get anemia?
Lack of androgens
What are common metastases to adrenal?
Lung and breast
Before you treat severe hypothyroidism, make sure you treat WHAT?
Any adrenal insufficiency that may be present! If you give thyroid before treating it, it will get way worse!
Where do you most prominently seen hyperpigmentation due to increased ACTH levels?
buccal mucosa, skin creases, skin
subnormal response of plasma cortisol following cosyntropin (synthetic ACTH) is definitive and diagnostic of adrenocortical insufficiency—vs. normal patients who have a brisk increase in cortisol after cosyntropin administration.
Abnormal cosyntropin (ACTH) stimulation test - how to diagnose adrenal insufficiency
↑ ACTH, but no ↑ in 11-deoxycortisol—vs. normal patients who have ↑ ACTH and ↑ 11-deoxycortisol in response to metyrapone administration.
Abnormal metyrapone test:
What is the normal dose of levothyroxine for a young person with hypothyroidism?
125 micrograms thyroxine
What is the normal dose of levothyroxine for an older person?
75-100 micrograms thyroxine
Quick physical exam test for hypothyroid?
Slow, diminished ankle jerk
