NRNP 6550 FINAL EXAM REVIEW EXAM
QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS
Addison's Disease
- Primary adrenal insufficiency is dysfunction of adrenal cortices.
- Secondary adrenal insufficiency is result of insufficient ACTH.
S&S: weakness, fatigue, HA, nausea, hyperpigmented skin (lack of cortisol), sparse axillary hair, abd pain.
Diagnose: Abd CT, head CT, Cortrosyn ACTH stim test, pan culture.
Findings: low Na, hyperK, low glucose, elevated ESR, neutropenia, esosiniphilia, lymphocytosis, hyperCal,
low plasma cortisol, elevated BUN, metabolic acidosis.
Treat: NS or D5NS, IV hydrocortisone, electrolyte replacement, monitor for decomp., IV abx if indicated.
Cushing's Syndrome
- Hypercortisolemia (iatrogenic from glucocorticoid use, pituitary tumors, and ectopic ACTH-secretion
from tumors outside of the pituitary).
QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS
Addison's Disease
- Primary adrenal insufficiency is dysfunction of adrenal cortices.
- Secondary adrenal insufficiency is result of insufficient ACTH.
S&S: weakness, fatigue, HA, nausea, hyperpigmented skin (lack of cortisol), sparse axillary hair, abd pain.
Diagnose: Abd CT, head CT, Cortrosyn ACTH stim test, pan culture.
Findings: low Na, hyperK, low glucose, elevated ESR, neutropenia, esosiniphilia, lymphocytosis, hyperCal,
low plasma cortisol, elevated BUN, metabolic acidosis.
Treat: NS or D5NS, IV hydrocortisone, electrolyte replacement, monitor for decomp., IV abx if indicated.
Cushing's Syndrome
- Hypercortisolemia (iatrogenic from glucocorticoid use, pituitary tumors, and ectopic ACTH-secretion
from tumors outside of the pituitary).
