NUR 301 Spring 2018 Endocrine Pathologies (except DM) .doc

Adrenocortical hyperfunction glucocorticoid cushing

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Adrenocortical Hyperfunction - Glucocorticoid -Cushing Disease or Syndrome Cushing Syndrome - chronic hypercortisolism with/without primary involvement Cushing Disease - pituitary dependent hypercortisolism Cushing Like Syndrome - from exogenous cortisone 1. Etiology 2. Clinical manifestations moon face, buffalo hump and truncal obesity glucose intolerance, osteoporosis, thin hair, purple striae, large abdomen, acne, facial hair, hyperpigmentation, thin extremities, altered affect, infections 3. Diagnosis urinary free cortisol levels, dexamethasone suppression test 4. Treatment cause, steroids, surgery, radiation B. Adrenal Hyperfunction - mineralocorticoid - Hyperaldosteronism excessive aldosterone secretion by the adrenal gland 1. Primary aldosteronism (Conn Disease) a. Etiology adrenal cortex pathology b. Clinical manifestations hypertension, renal K+ wasting c. Pathophysiology sodium reabsorption with hypervolemia 7
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2. Secondary hyperaldosteronism a. Etiology b. Pathophysiology (secondary hyperaldosteronism) increased circulating blood volume from renin secretion 3. Clinical manifestations hypertension, hypokalemia 4. Diagnosis BP, electrolytes, aldosterone levels, aldosterone suppression test 5. Treatment C. Adrencortical Hypofunction inadequate stimulation of the adrenal glands by ACTH decreased production of cortical hormones by the adrenal gland 1. Primary adrenal cortical insufficiency - Addison Disease a. Etiology b. Pathophysiology elevated ACTH levels with low corticosteroid levels c. Clinical manifestations weakness and fatigue, anorexia, NVD, hypoglycemia, mental changes hyperpigmentation, hypotension d. Diagnosis serum cortisol levels, aldosterone and 17 ketosteroid depression e. Treatment hormone replacement and diet D. Adrenal Medulla Hyperfunction - Pheochromacytoma 1. Etiology catecholamine producing tumore of adrenal medulla 2. Pathophysiology norepinephrine production 3. Clinical manifestations hypertension, flushing, diaphoresis, tachycardia, palpitations, sweating 4. Diagnosis serum and urine catecholamine levels 5. Treatment surgery 8
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E. Adrenal Medulla Hypofunction - rare - post adrenalectomy rbe rbe spring 2018 9
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