Adrenal Insufficiency Flashcards Preview

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Flashcards in Adrenal Insufficiency Deck (15)
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0
Q

Other causes of primary renal insufficiency?

A
  1. Chronic granulomatous infections (histoplasmosis, Coccidioides)
  2. Adrenal hemorrhage
  3. Adrenal metastasis (lung, breast, Stomach cancer)
  4. X-linked adrenoleukodystrophy
1
Q

symptoms and labs of adrenal insufficiency? Most common cause? Next step?

A

Sx: Orthostatic hypotension, abdominal pain, constitutional symptoms

Labs: Hyponatremia, hyperkalemia, acidosis, hypoglycemia

Idiopathic autoimmune destruction

Draw cortisol level, give saline with glucose and stress doses of corticosteroids

2
Q

Patients with AIDS develop adrenal involvement as a result of these infections?

A

CMV, MAI

3
Q

In primary renal insufficiency, patient deficient in?

A

Cortisol and aldosterone

4
Q

secondary adrenal insufficiency? Most common cause?

A

Lack of ACTH. Exogenous corticosteroids

5
Q

Symptoms of acute renal insufficiency?

A

Weakness, nausea/vomiting, fever, hypotension, tachycardia

6
Q

Laboratory findings in acute adrenal sufficiency?

A

Hyponatremia, hypoglycemia,

hyperkalemia, metabolic acidosis,

eosinophilia, azotemia

7
Q

Septic shock versus acute adrenal insufficiency?

A

Hyperglycemia versus hypoglycemia

8
Q

Effect of pressers on acute adrenal insufficiency? Best tx?

A

Refractory to pressors. Will reverse which steroids

9
Q

Difference in signs of primary versus secondary adrenal insufficiency?

A

Secondary: no hyperkalemia or volume depletion (RAAS still makes ALDO) or hyperpigmentation (no ACTH)

10
Q

Diagnosing Adrenal insufficiency?

A
  1. Morning plasma cortisol level <5

2. 7+ increase in cortisol level (Or max level of 18 ug) after 250 ug ACTH

11
Q

Gold standard for testing entire HPA axis?

A

Insulin-glucose tolerance test

12
Q

Treatment of acute renal insufficiency?

A

D5, with NS and steroids (hydrocortisone 100 mg every six – eight hours)

13
Q

Why use hydrocortisone?

A

Provides both glucocorticoid and mineralocorticoid activity

14
Q

Long-term treatment for patients with primary adrenal insufficiency?

A

Hydrocortisone 25 to 30 mg

Fludrocortisone .1-.2 mg

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