NURS 5433 MODULE 5 ENDOCRINE & THYROID NEW EXAM WITH
ACCURATE ANSWERS FULL SET (A+)
What is APS?
autoimmune polyendocrine syndrome. There are 2 types. Type 1 is inherited and is
autosomal recessive. Type 2 is ushua from DM, celiac, immune thyroid disease and
hypogonadism
What is secondary hypocortisolism?
results from low levels of ACTH being produced. This will cause atrophy of the adrenal
glands because they are not being stimulated enough to make cortisol
What are s/s of secondary hypocortisolism?
same as addison's, but w/o hyperpigmentation and will have normal aldosterone and
potassium levels
What are s/s of addison's disease?
all will occur slowly over time.
fatigue, weakness, weight loss, n/v/d, low BP, hyperpigmentation, irritability,
depression, craves salty foods, irregular periods, loss of pubic/axillary hair
What diagnostics are needed for addison's disease?
Plasma cortisol level at 8am. If it is less than 3mcg/dl. it is addison's.
Can also draw ACTH. and if it is greater than 200pg/ml it is even more consistent with
addison's.
MUST confirm with cosyntropin stimulation test
What is the cosyntropin stimulation test?
, you will be administering synthetic ACTH to a patient as IM injection. You will then draw
their blood 45 minutes later to measure a serum cortisol. If the cortisol levels did not
increase after given ACTH. you can confirm primary failure of adrenal glands Addisons
What lab imbalances would you expect to see in a patient that has a history of addison's
disease?
Low sodium, chloride and bicarbonate. High potassium. High calcium. High BUN/Cr.
CBC will show normocytic/normochromic anemia and eosinophillia with lymphocytosis
will see ST segment changes because of high K levels.
What will an abominal scan show in a patient with addion's disease?
small adrenal glands (because they have atrophied). if it is non-autoimmune disease the
adrenals may be enlarged.
name 5 DDX for addison's disease
hyperparathyroid, secondary or tertiary adrenocortical insufficiency, depression,
anemia, sprue, anorexia, heavy metal poisoning
How do you manage a patient with addison's?
Correct precipitating factors. adequate sodium intake, low potassium diets, calcium and
vitamin D supps. Replace fluids with IV NS.
Glucocorticoid supplementation with a synthetic hydrocortison 15-20mg in the morning,
then 10mg in late afternoon. Or can do mineralocorticoid supplements with
fludrocortison 0.05-0.2mg/dl
always refer these patients out to endocrinology
what are the 5 S's of addison management
ACCURATE ANSWERS FULL SET (A+)
What is APS?
autoimmune polyendocrine syndrome. There are 2 types. Type 1 is inherited and is
autosomal recessive. Type 2 is ushua from DM, celiac, immune thyroid disease and
hypogonadism
What is secondary hypocortisolism?
results from low levels of ACTH being produced. This will cause atrophy of the adrenal
glands because they are not being stimulated enough to make cortisol
What are s/s of secondary hypocortisolism?
same as addison's, but w/o hyperpigmentation and will have normal aldosterone and
potassium levels
What are s/s of addison's disease?
all will occur slowly over time.
fatigue, weakness, weight loss, n/v/d, low BP, hyperpigmentation, irritability,
depression, craves salty foods, irregular periods, loss of pubic/axillary hair
What diagnostics are needed for addison's disease?
Plasma cortisol level at 8am. If it is less than 3mcg/dl. it is addison's.
Can also draw ACTH. and if it is greater than 200pg/ml it is even more consistent with
addison's.
MUST confirm with cosyntropin stimulation test
What is the cosyntropin stimulation test?
, you will be administering synthetic ACTH to a patient as IM injection. You will then draw
their blood 45 minutes later to measure a serum cortisol. If the cortisol levels did not
increase after given ACTH. you can confirm primary failure of adrenal glands Addisons
What lab imbalances would you expect to see in a patient that has a history of addison's
disease?
Low sodium, chloride and bicarbonate. High potassium. High calcium. High BUN/Cr.
CBC will show normocytic/normochromic anemia and eosinophillia with lymphocytosis
will see ST segment changes because of high K levels.
What will an abominal scan show in a patient with addion's disease?
small adrenal glands (because they have atrophied). if it is non-autoimmune disease the
adrenals may be enlarged.
name 5 DDX for addison's disease
hyperparathyroid, secondary or tertiary adrenocortical insufficiency, depression,
anemia, sprue, anorexia, heavy metal poisoning
How do you manage a patient with addison's?
Correct precipitating factors. adequate sodium intake, low potassium diets, calcium and
vitamin D supps. Replace fluids with IV NS.
Glucocorticoid supplementation with a synthetic hydrocortison 15-20mg in the morning,
then 10mg in late afternoon. Or can do mineralocorticoid supplements with
fludrocortison 0.05-0.2mg/dl
always refer these patients out to endocrinology
what are the 5 S's of addison management
