MEDSURG II ENDOCRINE CORRECT STUDY
QUESTIONS AND ANSWERS SURE A+
✔✔what are 2 dx test for DI? - ✔✔water deprivation tests: peeing 8L a day, deprive of
water for 12 hours- should concentrate urine
brain says dehydrated, need to retain water, should concentrate urine= if not after 12
hours= DI
desmopressin (DDVAP) test: synthetic ADH to retain water, concentrate urine
✔✔what interventions might we use for DI? - ✔✔hormone therapy
fluid therapy bc hypotensive
low sodium diet if not responding to therapy
thiazide diuretics (block ADH on kidneys where issue is)
✔✔what condition occurs from:
1. low ADH
2. high ADH
what is the urine osmolality for each? - ✔✔1. Diabetes insipidus- low
2. SIADH- high
✔✔adrenal cortex hyperfunction vs hypofunction - ✔✔hyper: cushing's
hypo: addison's
✔✔what type of issue would it be if there are too much glucocorticoids but ACTH is
through the roof and releasing is negative? - ✔✔secondary (pituitary issue)
✔✔what type of issue would it be if the releasing and stimulating hormone are zero, but
the glucocorticoids are high? - ✔✔primary (organ issue)
, ✔✔what line does cushings primarily affect of the adrenal cortex? -
✔✔mineralcorticoids- so too much aldosterone= retain water and sodium, excrete K+
✔✔what is the most common cause for negative feedback with the adrenal gland? Why
is this important? - ✔✔steroids affect gluco and mineralcorticoids
atrophies and shuts off glands bc too much
so never abruptly discontinue steroids!!
✔✔primary cause of Cushing's - ✔✔excess corticosteroids
✔✔common causes of Cushing's besides excess corticosteroids - ✔✔iatrogenic (use
administering exogenous), ACTH secreting pituitary adenoma, adrenal tumors, ectopic
tumor ACTH production
✔✔what type of issue is an ACTH secreting tumor?
adrenal tumors? - ✔✔secondary (pituitary issue)
primary
✔✔what are manifestations of excess glucocorticoids? - ✔✔1. hyperglycemia (damages
arteries)
2. muscle wasting
3. loss of bone matrix- osteoporosis and back pain
4. loss of collagen- thin skin, easy bruising
5. delay wound healing
✔✔manifestations from excess mineralocorticoids - ✔✔1. HTN (too much water)
2. hypokalemia (excreted by aldosterone= dysrhythmias)
✔✔manifestations of excess androgen - ✔✔acne, virilization in women- amenorrhea,
hirsutism, decrease libido, feminization in men
✔✔s/s on assessment for Cushing's - ✔✔weight gain, prolonged wound healing, easy
bruising, bone pain, trunchal obesity, moon face, buffalo hump thinning of hair, striae,
etc
✔✔3 ways to test for adrenal issues based on cortisol - ✔✔we want confirmation of
increased cortisol levels--> measure sugar and blood in urine
1. midnight or late night salary cortisol
2. low dose dexamethasone suppression test
3. 24 hour urine cortisol
QUESTIONS AND ANSWERS SURE A+
✔✔what are 2 dx test for DI? - ✔✔water deprivation tests: peeing 8L a day, deprive of
water for 12 hours- should concentrate urine
brain says dehydrated, need to retain water, should concentrate urine= if not after 12
hours= DI
desmopressin (DDVAP) test: synthetic ADH to retain water, concentrate urine
✔✔what interventions might we use for DI? - ✔✔hormone therapy
fluid therapy bc hypotensive
low sodium diet if not responding to therapy
thiazide diuretics (block ADH on kidneys where issue is)
✔✔what condition occurs from:
1. low ADH
2. high ADH
what is the urine osmolality for each? - ✔✔1. Diabetes insipidus- low
2. SIADH- high
✔✔adrenal cortex hyperfunction vs hypofunction - ✔✔hyper: cushing's
hypo: addison's
✔✔what type of issue would it be if there are too much glucocorticoids but ACTH is
through the roof and releasing is negative? - ✔✔secondary (pituitary issue)
✔✔what type of issue would it be if the releasing and stimulating hormone are zero, but
the glucocorticoids are high? - ✔✔primary (organ issue)
, ✔✔what line does cushings primarily affect of the adrenal cortex? -
✔✔mineralcorticoids- so too much aldosterone= retain water and sodium, excrete K+
✔✔what is the most common cause for negative feedback with the adrenal gland? Why
is this important? - ✔✔steroids affect gluco and mineralcorticoids
atrophies and shuts off glands bc too much
so never abruptly discontinue steroids!!
✔✔primary cause of Cushing's - ✔✔excess corticosteroids
✔✔common causes of Cushing's besides excess corticosteroids - ✔✔iatrogenic (use
administering exogenous), ACTH secreting pituitary adenoma, adrenal tumors, ectopic
tumor ACTH production
✔✔what type of issue is an ACTH secreting tumor?
adrenal tumors? - ✔✔secondary (pituitary issue)
primary
✔✔what are manifestations of excess glucocorticoids? - ✔✔1. hyperglycemia (damages
arteries)
2. muscle wasting
3. loss of bone matrix- osteoporosis and back pain
4. loss of collagen- thin skin, easy bruising
5. delay wound healing
✔✔manifestations from excess mineralocorticoids - ✔✔1. HTN (too much water)
2. hypokalemia (excreted by aldosterone= dysrhythmias)
✔✔manifestations of excess androgen - ✔✔acne, virilization in women- amenorrhea,
hirsutism, decrease libido, feminization in men
✔✔s/s on assessment for Cushing's - ✔✔weight gain, prolonged wound healing, easy
bruising, bone pain, trunchal obesity, moon face, buffalo hump thinning of hair, striae,
etc
✔✔3 ways to test for adrenal issues based on cortisol - ✔✔we want confirmation of
increased cortisol levels--> measure sugar and blood in urine
1. midnight or late night salary cortisol
2. low dose dexamethasone suppression test
3. 24 hour urine cortisol
