Adrenal Disorders
***In any endocrine disease it is CRUCIAL to understand the axis each hormone is associated with to better understand the test results and proper management***
Jorge Muniz, creator of Medcomic, is an artist and absolute genius. Using his representations of different pathologies definitely helped me better grasp subjects in PA school.
PANCE Prep Pearls has an incredible breakdown of the adrenal disorders with great pathophysiology, mnemonic aides, and charts to consider when interpreting lab values.
Adrenal Insufficiency
Primary (Addisons Disease) vs Secondary Adrenal Insufficiency
**LACK OF CORTISOL**
Hypoglycemia, Hyponatremia, HYPERkalemia, hyperpigmentation (only in Addisons)
Understand screening and diagnosis for primary and secondary
Tx: Cortisol replacement with glucocorticoids.
Adrenal Crisis
Abrupt worsening of adrenal insuffciency
Patient is presenting with ‘shock’ features with hypotension and lab values featured above
Look for the patient who had major surgery and/or did not taper steroids who is hypotensive
Cushing syndrome
Cushing Syndrome does NOT equal Cushing Disease
Cushing Syndrome = excess cortisol
**Moon face, central obesity**
Hyperglycemia, Hypertensive, Hypokalemic
Cushing DISEASE think Cranium (get brain MRI to look for pituitary tumor)
For additional questions and explanations click below!
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