Thompson 1

Question 1

What glucose issure can be present in up to 20% of those with Conns?

What acid base issue may they have

Answer 1

• Glucose issue = glucose intolerance
• Acid base issue = metabolic alcolosis

Question 2

Epinephrine vs norepinephrine

Answer 2

• epi = fight or flight, increases HR, BP, dilates pupils, redirects blood to muscles
• Norepinephrine = increases BP

Question 3

what does cortisol do

Answer 3

• regualtes BP, cardiac function, immune system, mood, insulin metaboism

Question 4

what does aldosterone do

Answer 4

• BP
• water balance

Na balance

• helps kidney keep Na and get rid of K+

Question 5

Pheocrhomocytoma

Answer 5

• Growth on the adrenal leads to increased production of Epi and NE
• Called 10% tumor

–> malignant (10% of time)

–> 2 sided (10% of time) etc, in kids, familial, recur

• SYMPTOMS = Rapid HR, high BP, flushed, anxiety, pale (increased fight or flight)
• TX = surgical removal

Question 6

POTS –> type of autonomic failure

Answer 6

• Postural orthostatic tachycardiac syndomre = a combo of symptoms from variety of causes (viral, CA, adrenals)
• Faiting, CP, SOB, fatigue
• Orthostatic hypotension (lots of passing out)
• Meds to treat symptoms

Question 7

ADDISONS DISEASE

Answer 7

• Failure of adrenals to make enough cortisol (sometimes aldosterone too)
• Lach of ACTH –> pituitary dysfunction (secondary)

–> keep making aldosterone

• Lack of adrenal function/response (primary)
• SYmptoms = wt loss/decreased appetite, fatigue, low BP, darkening of skin, darkening around teeth

- LOW GLU, LOW Na AND HIGH K

- Not enough cortisol and pts gets sick –> can be fatal

• TX = STEROIDS (inrease during stress, surgery, illness)

–> STRESS DOSE GIVEN WHEN BODY WILL BE STRESSED

Question 8

CUSHINGS

Answer 8

• opposite of addisions (too much steroids) too much ACTH
• Symptoms = trunk obesisty, buffalo hump, HYPERTENSION, Hyperglycema, hypernatremia, hypokalemia, moon face, purple stretch marks, easy fractures
• long term = obesity, osteoporosis, diabetes, muscle weakness, skin issues
• Cause = Iatrogenic (steroid use), etc
• TX = taper steroids, surgery to remove tumors, signifor (reduce cortisol)

*** LIKE ADDISONS, CURSHINGS MAY REQUIRE STRESS DOSING OF STEROIDS DURING ILLNESSES, PRIOR TO SURGERY, ETC

Question 9

CONN’S DISEASE (HYPERALDOSTERONISM)

Answer 9

• overproduction of aldosterone (benign tumor usual, bilateral adrenal hyperplasia)
• TX = take out adrenal or spiranolactone (blocks aldosterone)
• SYMP: HYPERTENSION, LOW K, Headache, MUSCLE WEAKNESS
• SUSPECT HYPERALDOSTERONISM IN PT WITH RESISTANT HTN and LOW POTASSIUM