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I found this surfing the net and thought you all would like it..

here is the link http://www.uams.edu/m2006/MPCC4notes.htm

Adrenal Disorders

1/23/03 JK

Cushing's

Symptoms:

- Weight gain (centrally)

- Moon face and plethora

- Muscular weakness (proximal)

- Malaise

- Depression and Psychosis

- Oligomenorrhoea or amenorrhoea

- Hirsuties

- Strider, acne, skin thinning, and bruising

- Polyuria, nocturia

- Diabetes

- Na+/K+ retention ---> edema

- Poor wound healing

Syndrome: low ACTH and high Cortisol (problem is in the adrenal or somewhere besides pituitary)

Disease: excess cortisol due to increased ACTH from the pituitary

Adrenal Insufficiency

Primary:

- Idiopathic ('s)

- Tuberculosis

- Fungal Infections

- Adrenal hemorrhages

- Congenital adrenal hypoplasia

- Sarcoidosis

- Metastatic neoplasia

Secondary:

- After exogenous glucocorticoid intake

- After cure of Cushing's Syndrome (removal of endogenous gluocorticoids)

- Hypothalamic and Pituitary lesions

Cortisol is decreased and ACTH is increased:

Give an ACTH stimulation test: Give the patient ACTH, and if they make cortisol, the problem is in the pituitary. If they do not make cortisol, problem is in "the axis." Could be pituitary or adrenal glands.

Symptoms:

- Weakness

- Skin pigmentation increased (Vitiligo- areas with no skin pigmentation at all)

- Loss of weight, anorexia, vomiting, diarrhea

- Hypotension

- Salt craving

- Hypoglycemic episodes

Treatment:

- Fluids and Cortisol

If found in Meningitis, the patient will display purpura ecchymosis (hemorrhage of the skin).

Congenital Adrenal Hyperplasia

- 21-hydroxylation deficiency: salt wasting syndrome

Excess testosterone---> Seminiferous Tubule wasting----> infertility

- In childhood, the patient will have been exceptionally tall, but as puberty approaches, the epiphyseal plates will close prematurely, and all the other children will outgrow the Hyperplastic one.

Hyperaldosteronism

- Hypertension

- Hyperkalemia

- K+ in the urine

- Cohn's Syndrome

Pheochromocytoma

- Intermittent hyper or hypotension

- Headache, palpitations, sweating, and dizziness

- Glycosuria