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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) School Study Aid
Adrenal Gland (Advanced)
- Characteristics
- Adrenal Cortex
- Zona Glomerulosa
- Aldosterone
- Zona Fasciculata
- Cortisol
- Zona Reticularis
- Androgens
- Adrenal Medulla
- Chromaffin Cells
- Epinephrine & Norepinephrine
2 mins
Addison's Disease
- Mechanism
- Chronic 1° Adrenal Insufficiency
- Atrophy
- Destruction
- Symptoms
- Deficiency In Cortisol And Aldosterone
- Skin Hyperpigmentation
- Increased POMC
- Hypotension
- Hyperkalemia
- Acidosis
- Addisonian Crisis
- Diagnosis
- ACTH (Cosyntropin) Stimulation Test
- Treatment
- Exogenous Cortisol
2 mins
Addison's Disease Assessment
- Assessment
- Deficiency of Cortisol and Aldosterone
- Irritability
- Hyperkalemia
- Muscle Weakness
- Skin Hyperpigmentation
- Hyponatremia
- Hypotension
- Hypoglycemia
- Considerations
- Addisonian Crisis
2 mins
Addison's Disease Intervention
- Drug Therapy
- Hydrocortisone
- 2/3 Dose in Morning
- 1/3 Dose in Late Afternoon
- Fludrocortisone
- Androgen Replacement Therapy
- Considerations
- Salt Additives
- Increase Dosage During Stress and Infection
- Medic Alert Bracelet
- Lifelong Hormone Therapy
2 mins
Fludrocortisone
- Mechanism of Action
- Aldosterone Analog
- Indications
- Addison’s Disease (Primary Adrenal Insufficiency)
- Congenital Adrenal Hyperplasia
- Side Effects
- Cushing Syndrome
- Edema
- Congestive Heart Failure Exacerbation
- Hyperpigmentation
2 mins
Addisonian Crisis
- Assessment
- Severe Symptoms
- Shock
- Interventions
- High-Dose Hydrocortisone
- Large Volumes of IV Fluid
- Insulin with Dextrose
- Kayexalate
- Loop or Thiazide Diuretics
2 mins
Cushing's Syndrome Characteristics
- More Common in Women
- Exogenous Etiologies
- Glucocorticoids
- Endogenous Etiologies
- Decreased ACTH
- Primary Adrenal Disease
- Increased ACTH
- Pituitary Adenoma (Cushing's Disease)
- Paraneoplastic: Small Cell Carcinoma
- CRF-releasing Tumors
2 mins
Cushing's Syndrome Assessment
- Assessment
- Increased Cortisol Levels
- Truncal Obesity
- Purple Abdominal Striae
- Buffalo Hump
- Decreased Bone Density
- Moon Face
- Thinning Skin
- Hyperglycemia
- Hypertension
- Considerations
- Long Term Glucocorticoid Use
- Immunosuppression
2 mins
Cushing's Syndrome Symptoms And Diagnosis
- Symptoms/Findings
- Osteoporosis
- Amenorrhea
- Truncal Obesity
- Skin Changes
- Buffalo Hump
- Immune Suppression
- Moon Facies
- Hypertension
- Decreased Insulin Sensitivity
- Diagnosis
- 24-hour urine free Cortisol
- Dexamethasone Suppression Test
2 mins
Hyperaldosteronism Overview
- Mechanism
- Adrenal Glands
- Increased Aldosterone
- Aldosterone Escape Mechanism
- Clinical Findings
- No Significant Edema
- Hypertension
- Hypokalemic Metabolic Alkalosis
- Types
- Primary Hyperaldosteronism
- Secondary Hyperaldosteronism
- Pseudohyperaldosteronism
3 mins
Primary Hyperaldosteronism
- Etiology
- Increased Aldosterone Secretion
- Adrenal Adenoma
- Bilateral Adrenal Hyperplasia
- Clinical Features
- Hypertension
- Hypokalemic Metabolic Alkalosis
- No Significant Edema
- Diagnosis
- Increased Aldosterone
- Decreased Renin
- Abdominal CT Scan
- Management
- Aldosterone Antagonists
- Surgery
3 mins
Secondary Hyperaldosteronism
- Etiologies
- Renal Artery Stenosis
- Reninoma
- Chronic Disease of Liver, Kidney, or Heart
- Clinical Features
- Edema
- Hypertension
- Hypokalemic Metabolic Alkalosis
- Diagnosis
- Increased Aldosterone
- Increased Renin
- Treatment
- Treat Underlying Disorder
- Aldosterone Antagonists
3 mins
Pheochromocytoma
- Cause/Mechanism
- Adrenal Medulla Tumor
- Increased Catecholamines
- Assessment
- Episodic Hypertension
- Diaphoresis
- Abdominal or Chest Pain
- Interventions
- Surgery
- Antihypertensives
- Phenoxybenzamine
- Metyrosine (Demser)
- Considerations
- Do Not Palpate Abdomen
3 mins
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