MEDSURG II ENDOCRINE test paper QUESTIONS
AND ANSWERS SURE A+
✔✔what do we use for bilateral adrenal hyperplasia ? - ✔✔potassium sparing diuretic
CCBs for lowering BP
dexamethasone to lower hyperplasia
✔✔what is hyper function pheochromocytoma? - ✔✔adrenal medulla (epi and norepi)
hyper section
(cushings was all three of cortex, Conn's was aldosterone, this is medulla)
so epi causes tachycardia and contractility, norepi causes vasoconstriction
✔✔s/s from hyper function pheochromocytoma - ✔✔massive HTN and tachycardia
HA, palpitations, sweating, abd or chest pain
✔✔how do we dx hyperfunction pheochromocytoma? - ✔✔24 hour urine for
metanephrines (metabolites of nor epi and epi)
✔✔what do we do for hyperfunction pheochromocytoma ? - ✔✔remove tumor
- before, need alpha adrenergic blockers= zosins to block vsoconstriction
-and beta adrenergic blocker
✔✔what is Addison's disease?
usual cause? - ✔✔hypo secretion from adrenal gland- all three but mainly
mineralcorticoids
autoimmune - damaging adrenal gland
✔✔what kind of disease is Addison's? - ✔✔primary endocrine, but can get hypo
function from secondary or tertiary problem
, ✔✔what is iatrogenic Addisons? - ✔✔from giving steroids to patient, negative feedback
atrophies gland, get once stop steroid
✔✔negative feedback system order for Addisons - ✔✔corticotropin releasing hormone
(CRH), then ACTH, then adrenal cortex hormones
✔✔manifestations of Addisons - ✔✔slow and hidden= insidious
anorexia, nausea, progressive weakness, fatigue, weight loss
✔✔what happens as a result of too much ACTH in the system for Addison's that gives
away that it is primary Addison's and why? - ✔✔because there is nothing from the
adrenal gland (primary issue), pituitary turns on and secretes ACTH= this stimulates
melanocytes= HYPERPIGMENTATION
wouldn't have with secondary Addisons because no ACTH secretion
✔✔2 dx tests for Addisons - ✔✔ACTH stimulation test
CRH stimulation test
✔✔explain the ACTH stimulation test - ✔✔see if adrenal glands ok, so IV inject ACTH
if ok: should put out hormones raising glucose and BP
+= if it works, disease in pituitary, secondary= not producing enough
-=primary disease because no effect
Addisons would have little or no increase in cortisol, and high ACTH
✔✔explain CRH stimulation test - ✔✔if have abnormal ACTH test, so IV CRH
Addisons have high ACTH with no cortisol
secondary would have absences of ACTH or delayed response
✔✔what would these look like for Addisons:
1. potassium
2. chloride, sodium, and glucose
3. RBCs
4. BUN
5. ECG
6. CT scan/MRI - ✔✔1. high
2. low
AND ANSWERS SURE A+
✔✔what do we use for bilateral adrenal hyperplasia ? - ✔✔potassium sparing diuretic
CCBs for lowering BP
dexamethasone to lower hyperplasia
✔✔what is hyper function pheochromocytoma? - ✔✔adrenal medulla (epi and norepi)
hyper section
(cushings was all three of cortex, Conn's was aldosterone, this is medulla)
so epi causes tachycardia and contractility, norepi causes vasoconstriction
✔✔s/s from hyper function pheochromocytoma - ✔✔massive HTN and tachycardia
HA, palpitations, sweating, abd or chest pain
✔✔how do we dx hyperfunction pheochromocytoma? - ✔✔24 hour urine for
metanephrines (metabolites of nor epi and epi)
✔✔what do we do for hyperfunction pheochromocytoma ? - ✔✔remove tumor
- before, need alpha adrenergic blockers= zosins to block vsoconstriction
-and beta adrenergic blocker
✔✔what is Addison's disease?
usual cause? - ✔✔hypo secretion from adrenal gland- all three but mainly
mineralcorticoids
autoimmune - damaging adrenal gland
✔✔what kind of disease is Addison's? - ✔✔primary endocrine, but can get hypo
function from secondary or tertiary problem
, ✔✔what is iatrogenic Addisons? - ✔✔from giving steroids to patient, negative feedback
atrophies gland, get once stop steroid
✔✔negative feedback system order for Addisons - ✔✔corticotropin releasing hormone
(CRH), then ACTH, then adrenal cortex hormones
✔✔manifestations of Addisons - ✔✔slow and hidden= insidious
anorexia, nausea, progressive weakness, fatigue, weight loss
✔✔what happens as a result of too much ACTH in the system for Addison's that gives
away that it is primary Addison's and why? - ✔✔because there is nothing from the
adrenal gland (primary issue), pituitary turns on and secretes ACTH= this stimulates
melanocytes= HYPERPIGMENTATION
wouldn't have with secondary Addisons because no ACTH secretion
✔✔2 dx tests for Addisons - ✔✔ACTH stimulation test
CRH stimulation test
✔✔explain the ACTH stimulation test - ✔✔see if adrenal glands ok, so IV inject ACTH
if ok: should put out hormones raising glucose and BP
+= if it works, disease in pituitary, secondary= not producing enough
-=primary disease because no effect
Addisons would have little or no increase in cortisol, and high ACTH
✔✔explain CRH stimulation test - ✔✔if have abnormal ACTH test, so IV CRH
Addisons have high ACTH with no cortisol
secondary would have absences of ACTH or delayed response
✔✔what would these look like for Addisons:
1. potassium
2. chloride, sodium, and glucose
3. RBCs
4. BUN
5. ECG
6. CT scan/MRI - ✔✔1. high
2. low
