PN3 EXAM 3 QUESTIONS AND
ANSWERS
DIC signs and symptoms
body clotting too much, body compensates and begins bleeding too much, clotting
begins again, hard to reverse, high mortality rate. Eventually run out of clotting factors
DIC Treatment
Fluid replacement and blood transfusion treat the cause
Addisonian Crisis Treatment
• Start rapid infusion of normal saline or dextrose 5% in normal saline.
• Initial dose of hydrocortisone sodium (Solu-Cortef) is 100 to 300 mg or
dexamethasone 4 to 12 mg as an IV bolus.
• Administer additional 100 mg of hydrocortisone sodium by continuous IV infusion over
the next 8 hours.
• Give hydrocortisone 50 mg IM concomitantly with hydration every 12 hours.
• Initiate an H2 histamine blocker (e.g., ranitidine) IV for ulcer prevention.
Acromegaly Signs and Symptoms
Progression may be slow
Facial swelling, HA, lethargy, sleep apnea, HTN, Infertility, muscle weakness, weight
gain
Enlarged skull
thick ears/nose, thick tongue, enlarged supraorbital, gigantism, sleep apnea, infertility,
HTN, weight gain
TX: Levothyroxine, Cortisone
**increase human growth hormone**
Cushing's Syndrome Signs and Symptoms
the excess secretion of cortisol from the adrenal cortex
· Moon face
"Buffalo Hump"
· Increases susceptibility to infection
· Males: gynecomastia
· Fat deposits in back
· Hyperglycemia
· CAN irritability
· NA and fluid retention
· This extremities
· GI distress
· Thin skin
· Purple striae
· Bruises and petechiae
Cushing Syndrome Diagnostic Tests
, ACTH levels are low
• Increased blood glucose level
• Decreased lymphocyte count
• Increased sodium level
• Decreased serum calcium level
CT scans, MRI, and arteriography.
Cushing Syndrome Treatment
cyproheptadine (Periactin) may be used because it interferes with ACTH production.
Mitotane (Lysodren) is an adrenal cytotoxic agent used for inoperable tumors causing
hypercortisolism.
Metyrapone (Metopirone), aminoglutethimide (Elipten, Cytadren), and ketoconazole use
different pathways to decrease cortisol production
Cushing Syndrome vs. Cushing Disease
DISEASE: is a malfunction of the Pituitary gland - Hypersecretion of ACTH
SYNDROME: is a malfunction of the Adrenal cortex - Hypersecretion of CORTISOL.
Happens regardless of the amount of ACTH provided by pituitary gland
Diabetes Incipidus Signs and Symptoms
"extreme water loss"
Cardiovascular Symptoms
• Hypotension
• Tachycardia
• Weak peripheral pulses
• Hemoconcentration
Kidney/Urinary Symptoms
• Increased urine output
• Dilute, low specific gravity
Skin Symptoms
• Poor turgor
• Dry mucous membranes
Neurologic Symptoms (when rapid dehydration)
• Decreased cognition*
• Ataxia*
• Increased thirst
• Irritability*
Diabetes Insipidus Diagnostic Tests
The 24-hour fluid intake and output is measured without restricting food or fluid intake.
DI is considered if urine output is more than 4 L during this period and is greater than
the volume ingested. The amount of urine excreted in 24 hours by patients with DI may
vary from 4 to 30 L/day.
Diabetes Insipidus Treatment
Urge the patient to drink fluids in an amount equal to urine output.
ANSWERS
DIC signs and symptoms
body clotting too much, body compensates and begins bleeding too much, clotting
begins again, hard to reverse, high mortality rate. Eventually run out of clotting factors
DIC Treatment
Fluid replacement and blood transfusion treat the cause
Addisonian Crisis Treatment
• Start rapid infusion of normal saline or dextrose 5% in normal saline.
• Initial dose of hydrocortisone sodium (Solu-Cortef) is 100 to 300 mg or
dexamethasone 4 to 12 mg as an IV bolus.
• Administer additional 100 mg of hydrocortisone sodium by continuous IV infusion over
the next 8 hours.
• Give hydrocortisone 50 mg IM concomitantly with hydration every 12 hours.
• Initiate an H2 histamine blocker (e.g., ranitidine) IV for ulcer prevention.
Acromegaly Signs and Symptoms
Progression may be slow
Facial swelling, HA, lethargy, sleep apnea, HTN, Infertility, muscle weakness, weight
gain
Enlarged skull
thick ears/nose, thick tongue, enlarged supraorbital, gigantism, sleep apnea, infertility,
HTN, weight gain
TX: Levothyroxine, Cortisone
**increase human growth hormone**
Cushing's Syndrome Signs and Symptoms
the excess secretion of cortisol from the adrenal cortex
· Moon face
"Buffalo Hump"
· Increases susceptibility to infection
· Males: gynecomastia
· Fat deposits in back
· Hyperglycemia
· CAN irritability
· NA and fluid retention
· This extremities
· GI distress
· Thin skin
· Purple striae
· Bruises and petechiae
Cushing Syndrome Diagnostic Tests
, ACTH levels are low
• Increased blood glucose level
• Decreased lymphocyte count
• Increased sodium level
• Decreased serum calcium level
CT scans, MRI, and arteriography.
Cushing Syndrome Treatment
cyproheptadine (Periactin) may be used because it interferes with ACTH production.
Mitotane (Lysodren) is an adrenal cytotoxic agent used for inoperable tumors causing
hypercortisolism.
Metyrapone (Metopirone), aminoglutethimide (Elipten, Cytadren), and ketoconazole use
different pathways to decrease cortisol production
Cushing Syndrome vs. Cushing Disease
DISEASE: is a malfunction of the Pituitary gland - Hypersecretion of ACTH
SYNDROME: is a malfunction of the Adrenal cortex - Hypersecretion of CORTISOL.
Happens regardless of the amount of ACTH provided by pituitary gland
Diabetes Incipidus Signs and Symptoms
"extreme water loss"
Cardiovascular Symptoms
• Hypotension
• Tachycardia
• Weak peripheral pulses
• Hemoconcentration
Kidney/Urinary Symptoms
• Increased urine output
• Dilute, low specific gravity
Skin Symptoms
• Poor turgor
• Dry mucous membranes
Neurologic Symptoms (when rapid dehydration)
• Decreased cognition*
• Ataxia*
• Increased thirst
• Irritability*
Diabetes Insipidus Diagnostic Tests
The 24-hour fluid intake and output is measured without restricting food or fluid intake.
DI is considered if urine output is more than 4 L during this period and is greater than
the volume ingested. The amount of urine excreted in 24 hours by patients with DI may
vary from 4 to 30 L/day.
Diabetes Insipidus Treatment
Urge the patient to drink fluids in an amount equal to urine output.
