Adrenal Disorders Flashcards Preview

Clin Med II - Endocrine > Adrenal Disorders > Flashcards

Flashcards in Adrenal Disorders Deck (18)
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1
Q

If you have secondary adrenal insufficiency, where is the problem?

A

pituitary gland

2
Q

when does cortisol peak?

A

around 5-7 a.m. (about an hour before you get up)

lowest in the late afternoon

3
Q

what is primary adrenal insufficiency?

A

Addison’s disease -

cortical problem in adrenal gland that knocks out production

4
Q

what is the most common cause of Addison’s disease worldwide?

A

TB

(fungal infection - histoplasmosis, cryptococcus, CMV)

5
Q

how much of the adrenal cortex must you lose in both glands to have adrenal insufficiency?

A

90%

6
Q

what is the most common cause of Addison’s disease in the US?

A

autoimmune

7
Q

what are the symptoms in chronic primary adrenal insufficiency?

A

weakness

tiredness

fatigue

anorexia

GI symptoms

salt craving

postural diziness

joint pain

8
Q

what are the electrolyte disturbances in primary AI?

A

hyponatremia

hyperkalemia

9
Q

what are some other laboratory findings in primary AI you might see?

A
  • Anemia
    • chronic disease - mild
    • pernicious anemia
  • volume loss
  • eosinophilia
  • elevated TSH (glucocorticoids suppress TSH)
10
Q

what is the treatment of primary adrenal insufficiency?

A

glucocorticoids (prednisone or hydrocortisone)

+

mineralocorticoids (fludrocortisone)

*make sure that patients have a medic alert bracelet

11
Q
A
12
Q

in secondary AI, what don’t you have?

A

dehydration and hyperkalemia

13
Q

what is more common in 2ndary adrenal insufficency?

A

hypoglycemia

WHY: no dehydration, patients tolerate AI longer and present with symptoms of glucorticoid deficiency and not mineralcorticoid deficiency

14
Q

where is aldosterone made in the adrenals?

A

zona glomerulosa

15
Q

how do we screen people for primary aldosteronism?

A

measure aldosterone to renin ratio

16
Q

what percentage of people over 60 have an incidental nodule on the adrenal?

“incidentaloma”

A

6-8%

17
Q

what do you do as treatment if there is aldosteronism unilaterally?

A

surgically remove the affected adrenal

18
Q
A