MDC IV FINAL COMPREHENSIVE EXAM
QUESTIONS AND SOLUTIONS
◉ Addison's disease.
Answer: What is adrenal gland hypofunction?
◉ ▪ If the patient remains alert and oriented x 3.
Answer: *Addison's Disease*
▪ How do you know the therapy is working?
◉ ▪ Glucocorticoid drugs *MUST be withdrawn slowly so you don't
wind up with Addison's or adrenal insufficiency*
▪ This allows for pituitary protection of ACTH and activation of the
adrenal cortex to produce cortisol.
Answer: *Addison's Disease*
▪ How do you discontinue glucocorticoid therapy to avoid
secondary adrenal insufficiency?
◉ *▪ Muscle weakness*
,▪ Muscle/joint pain
▪ Fatigue.
Answer: *Addison's Disease*
▪ Neuromuscular S/S
◉ *▪ Hypertension*
▪ Dependent edema
▪ Bruising
▪ Petechiae.
Answer: *Cushing's Disease aka hypercortisolism*
▪ Cardiovascular S/S
◉ *INCREASED*
• blood glucose level
• sodium level
• late-night salivary cortisol
**• urine cortisol**
*DECREASED*
• lymphocyte count
,• calcium level.
Answer: *Cushing's Disease aka hypercortisolism*
▪ Laboratory Tests
◉ *INCREASED*
*▪ potassium (K)*
▪ calcium (Ca)
▪ BUN
*DECREASED*
▪ serum cortisol
▪ salivary cortisol
▪ fasting blood glucose
*▪ sodium (Na)*.
Answer: *Addison's Disease*
▪ Laboratory Tests
◉ Sodium increases
Potassium decreases.
, Answer: In *hyperaldosteronism* what happens with potassium and
sodium? (Remember...it's the opposite of Addison's disease)
◉ *Heat intolerance* - they are sweaty!.
Answer: *Hyperthyroidism aka Grave's disease*
▪ Hallmark assessment
◉ Pheochromocytoma.
Answer: a benign tumor of the adrenal medulla that causes the gland
to produce excess epinephrine, so you are in a constant fight/flight
state.
◉ ▪ Do not smoke
▪ Do not drink caffeine
▪ Do not change position suddenly
▪ Eat a diet rich in calories, vitamins, and minerals (avoid tyramine
foods)
Any of the above can cause a hypertensive crisis (closely monitor
their BP!)
QUESTIONS AND SOLUTIONS
◉ Addison's disease.
Answer: What is adrenal gland hypofunction?
◉ ▪ If the patient remains alert and oriented x 3.
Answer: *Addison's Disease*
▪ How do you know the therapy is working?
◉ ▪ Glucocorticoid drugs *MUST be withdrawn slowly so you don't
wind up with Addison's or adrenal insufficiency*
▪ This allows for pituitary protection of ACTH and activation of the
adrenal cortex to produce cortisol.
Answer: *Addison's Disease*
▪ How do you discontinue glucocorticoid therapy to avoid
secondary adrenal insufficiency?
◉ *▪ Muscle weakness*
,▪ Muscle/joint pain
▪ Fatigue.
Answer: *Addison's Disease*
▪ Neuromuscular S/S
◉ *▪ Hypertension*
▪ Dependent edema
▪ Bruising
▪ Petechiae.
Answer: *Cushing's Disease aka hypercortisolism*
▪ Cardiovascular S/S
◉ *INCREASED*
• blood glucose level
• sodium level
• late-night salivary cortisol
**• urine cortisol**
*DECREASED*
• lymphocyte count
,• calcium level.
Answer: *Cushing's Disease aka hypercortisolism*
▪ Laboratory Tests
◉ *INCREASED*
*▪ potassium (K)*
▪ calcium (Ca)
▪ BUN
*DECREASED*
▪ serum cortisol
▪ salivary cortisol
▪ fasting blood glucose
*▪ sodium (Na)*.
Answer: *Addison's Disease*
▪ Laboratory Tests
◉ Sodium increases
Potassium decreases.
, Answer: In *hyperaldosteronism* what happens with potassium and
sodium? (Remember...it's the opposite of Addison's disease)
◉ *Heat intolerance* - they are sweaty!.
Answer: *Hyperthyroidism aka Grave's disease*
▪ Hallmark assessment
◉ Pheochromocytoma.
Answer: a benign tumor of the adrenal medulla that causes the gland
to produce excess epinephrine, so you are in a constant fight/flight
state.
◉ ▪ Do not smoke
▪ Do not drink caffeine
▪ Do not change position suddenly
▪ Eat a diet rich in calories, vitamins, and minerals (avoid tyramine
foods)
Any of the above can cause a hypertensive crisis (closely monitor
their BP!)
