Where is aldosterone secreted?
adrenal gland
what is hyperaldosteronism called?
Conn's syndrome
Conn's syndrome
increased Na, increased BP, decreased K+
What is hypoaldosteronism called?
Addisons Disease
S/S of Addison's Disease?
decreased Na, decreased BP, increased K+, fatigue, muscle weakness, dark skin
pigmentation, hypotension, hypoglycemia
s/s of Addisonian crisis
decreased LOC, hypotension, flu like symptoms (N/V)- call DR!!
Tx of addisons/ Addisonian crisis
First- FLUIDS!!! then steroids
Pheochromocytoma
a benign tumor of the adrenal medulla that causes the gland to produce excess
catecholamines
What does pheochromocytoma cause?
fight/ flight response
5 H's of pheochromocytoma
Hypertension (MOST DANGEROUS)
Headache
Hyperhidrosis (excess sweating)
Hypermetabolism
Hyperglycemia
Treatment of pheochromocytoma
adrenalectomy, elevate HOB 30 degrees, give alpha adrenergic blockers (SE:
hypotension, increased HR, nasal congestion), give beta blockers (hold if HR below 60)
Hyperthyroidism
high T3 and T4 and low TSH
S/S of hyperthyroidism
wt loss, HTN, anxious, goiter, exophthalmos, heat intolerance, thin skin
s/s of thyroid storm
fever, restlessness, N/V
tx of hyperthyroidism
thyroidectomy, radioactive iodine
hypothyroidism
, low T3 and T4, high TSH
s/s of hypothyroidism
wt gain, constipation, hypotension, depression, decreased HR, cold intolerance, goiter
tx of hypothyroidism
levothyroxine- MUST take every morning on an empty stomach for life. must continually
have levels checked
where are corticosteroids secreted?
pituitary gland
What is hypercortisolism?
Cushing's syndrome
S/S of Cushing's Syndrome?
moon face, purple striae, hyperglycemia, thin extremities, large trunk, osteoporosis, thin
skin- SAFETY, too much cortisol, fluid retention, HTN, increased Na, decreased K+
what is the biggest concern with Cushing's?
SAFETY- increased r/f infections
what causes Cushing's?
excess steroid use, pituitary tumor
treatment of Cushing's with pituitary tumor?
transsphenoidal hypophysectomy- check for clear fluid with halo/ glucose (CSF)
What is hypocortisolism?
Congenital adrenal hyperplasia
s/s of congenital adrenal hyperplasia?
ambiguous genitalia- females: masculine features, men- feminine features. Easier to
visually see in women
tx of congenital adrenal hyperplasia
steroid use
Normal serum osmolality
280-295
What is serum osmolality?
how concentrated blood is
with dehydration what will the concentration of serum osmolality be?
increased concentration
hypertonic blood
increased concentration- ex: hyperglycemia with DKA
hypotonic blood
decreased concentration- ex: fluid overload with SIADH
normal urine specific gravity
1.005-1.030
example of low urine specific gravity
DI (low concentration because the urine is really diluted d/t excess urination)
example of high urine specific gravity
SIADH (high urine concentration because you are not peeing and holding onto fluids)
what is SIADH
increased ADH secretion from the pituitary gland
s/s of SIADH
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