BMS 3 ENDO DISEASES

ADDISONS

ADDISONS

HYPOsecretion of glucoticoids

mineralocorticoids

androgens

medical emergency!! needs immediate tx and hormone replacement for lifeeee

ETIOLOGIES

-autoimmune (75-90%)

-TB

-metastatic cancer

CLINICAL MANIFESTATIONS

-skin pigmentation and mucosa

-gradual onset of weakness

-low BP

-low Na+

tx

-IV hydrocortison sodium

-glucosa

-IV isotonic sodium chloride solution

CUSHINGS SYNDROME

HYPERsecretion of glucocorticoids

-cortisol and cortisone

CHARACTERIZED BY:

-moon face

-buffalo hump

-hirsutism (excess hair around chin & mouth)

-pendulous abdomen with stria

-weakness

-mood swings

tx

-sx resection

-pasireotide (signifor)

PHEOCROMOCYTOMA

uncommon benign tumor of adrenal medulla

produces catecholamines (NE and epi)

CLINICAL MANIFESTATIONS:

-severe HA

-tachycardia

-diaphoresis and anxiety

-HTN episodes

-sweating and tremors

-increased risk for MI, HF, renal ischmeia, cerebrovascular accidents and sudden cardiac death

rule of 10’s! CBOM

10% children

10% bilateral

10% outside of adrenal

10% malignant

dx

elevated VMA an catecholamines

tx

removal

MULTIPLE ENDOCRINE NEOPLASIA SYNDROMES (MEN)

>autosomal dominant inheritance

-hyperplasia and tumors of endocrine glands

MEN type 1 (Werner)

3 P’s!

-parathyroid

-pancreas

-pituitary

MEN type 2a (sipple syndrome)

pheochromocytoma

medullary carcinoma of the thyroid

MEN type 2b or 3 (william syndrome)

pheochromocytoma

medullary carcinoma of the thyroid

*mucocutaneous neuroma

DIABETES MELLITUS

>chronic systemic disease

-insulin deficiency

-hyperglycemia

type 1 (no insulin production)

type 2 (reduced insulin production)

TYPE 2 DM

consists of an array of dysfunctions characterized by:

hyperglycemia resulting from the combination on

-resistance to insulin

-inadequate insulin secretion

-excessive or inappropriate glucagon secretion

TYPE 2 DM levels

fasting: > 126mg

2 hr OGTT: >200

A1C: 6.5%

BP: >135/80 mm Hg

first line of drug for Type 2 diabetes unless CI

metformin