Adrenal Probs

Question 1

Hypercortisolism

Answer 1

Hyper secretion of cortisol hormone

Question 2

primary hyperfunction

Answer 2

Disease of adrenal cortex
Too high of cortisol hormone levels

Cushing syndrome

Question 3

secondary hyperfunction

Answer 3

Disease of anterior pituitary
Increased release of ACTH triggering hormone

Cushing disease

Question 4

what is the most common cause of Cushing syndrome?

Answer 4

EXOgenous steroids

Question 5

Function of cortisol

Answer 5

increases blood sugar, oppose insulin
Protects versus physiological effects of stress
Suppresses immune and inflammatory processes
Breaks down proteins and fat
Increases blood cholesterol
Maintains vascular system, keeps BP up

Question 6

symptoms with too much cortisol

Answer 6

Increased glucose availability
Maintenance of vascular system
Protein breakdown
Fat breakdown
Suppression of immune and inflammatory response
CNS excitability

Question 7

what occurs with increased glucose availability?

Answer 7

Glucose intolerance
Hyperglycemia

Question 8

What occurs with maintenance of the vascular system and too much cortisol

Answer 8

HTN
Capillary friability
eccymoses

Question 9

what occurs with that break down and too much cortisol?

Answer 9

Redistribution of fat
Abdomen, shoulders, face

Question 10

what occurs with a suppressed immune and inflammatory response?

Answer 10

Impaired wound healing and immune response
Risk for infection

Question 11

what do mood swings and insomnia occur from?

Answer 11

CNS excitability

Question 12

what are common symptoms associated with Cushing syndrome?

Answer 12

Loss of libido
Thinning hair
Hirsutism– chest, areola, chin
thinning of extremities
Buffalo hump
Moon face
Apple shaped
Purple striae
Ekhymosis
Fragile skin
Osteoporosis
Hyperglycemia

Question 13

what would be the drug therapy for a pituitary or adrenal tumor?

Answer 13

Surgery, radiation

Question 14

t/f for Exogenesis steroid drug therapy, you would need to taper off slowly

Answer 14

True

Question 15

Addison’s disease

Answer 15

Hyposecretion of adrenal, cortisol hormones
Disease of adrenal cortex

Question 16

3 S’s

Answer 16

Salt – aldosterone
Sugar – glucose
Sex - androgen

Question 17

cause of Addison’s disease

Answer 17

Idiopathic**
Auto immune

Question 18

Pathogenesis of Addison’s disease

Answer 18

adrenal gland destroyed/damaged
ACTH & MSH are secreted in large amounts

Question 19

early s/sx Addison’s disease

Answer 19

Anorexia, weight loss
Fatigue, weakness, malaise
Electrolyte in balance
Skin hyper pigmentation

Question 20

Hyperaldosteronism

Answer 20

Sodium/water retention problems
Hyponatremia

Question 21

hypotension

Answer 21

Decreased vascular tone, CO, circulating blood volume

Results in fluid volume deficit

Question 22

hypercorticolism

Answer 22

No energy, weakness, fatigue
Hypoglycemia

Question 23

why does a patient experience hypoglycemia?

Answer 23

Cortisol usually raises blood sugar, not enough in Addison’s disease

Question 24

Salt craving due to

Answer 24

Decreased serum, sodium levels
Increased serum, potassium levels
Dehydration

Question 25

unsuppressed ACTH production results in

Answer 25

Hyper pigmentation Due to increased melanocyte, stimulating hormone

Question 26

Addisonian crisis

Answer 26

Acute adrenal insufficiency No cortisol to combat stress

Question 27

t/f addisonian crisis is a medical emergency

Answer 27

True

Question 28

causes of addisonian crisis

Answer 28

Sudden increase in stress with chronic condition Sudden cessation of serum corticosteroids Sudden loss of adrenal gland

Question 29

t/f cortical steroid therapy is not a lifelong process

Answer 29

False, it is

Question 30

pharm therapy

Answer 30

Dosing mimics natural release of hormones, mainly given at night

Question 31

should corticosteroid therapy be abruptly stopped

Answer 31

Never

Question 32

what should you do with the dosing of steroids with stress?

Answer 32

Increase the dosage

Question 33

pheochromocytoma

Answer 33

adrenal medulla disorder Rear tumor of adrenal medulla that produces excess catecholamines

Question 34

What are catecholamines

Answer 34

Epinephrine Norepinephrine

Question 35

is pheochromocytoma, benign or malignant

Answer 35

Benign

Question 36

t/f older adults are more at risk for pheochromocytoma

Answer 36

False, young to middle age, more at risk

Question 37

pathogenesis of pheochromocytoma

Answer 37

SNS stimulus Tumor cells secrete catecholamines

Question 38

s/sx pheochromocytoma

Answer 38

headache HTN *** Tachycardia Diaphoresis

Question 39

why is HTN the most common symptom?

Answer 39

Due to the activation of alpha one receptors on blood vessels

Question 40

drug therapy for pheochromocytoma

Answer 40

Preferred – surgery, removal of tumor Alpha 1 adrenergic blockers maybe used

Question 41

why would alpha adrenergic blockers be used?

Answer 41

Inoperable tumors 10 to 14 days prior to operation to Reduce risk of a cute hypertension