Endocrine III

what happens with low aldosterone to K+

decreased excretion so higher in teh blood

what ahppens in the cortical collecting duct

principal epithelial cells

K+ excretion

Na+ reabsorption

Cl- reabsorption

what are the causes of hypoadrenocorticism

adenitis

idiopathic

immune mediated

adrenal haemorrhage

waht are the distinguishing featrues of iatrogenic hyperadrenocorticism

clinical signs of HAC

no increase on LDDT or ACTH stimulation test

what happens in the atypical presentation

only lack glucocorticoids

what are the renal clinical signs

PUPD

incontinency

dehydration

what are teh general ones

lethargy

weakness

hypothermia

abdominal pain

shivering and shaking

hyperpigmentation

biochemistry findings

lower NA+

increased K+

increased phosphate due to dehydration

increased ca2+ (cardioprotective)

decreased albumin slighly

lower cholesterol and glucose

increased AST, ALP, ALT

more urea and creatinine due to dehydration

what is the screening test and value

55mmol/L

measuring cortisol basal

what if cortisol increases on ACTH stimulation

measure aldosteorne

reasons for psuedohyperkalaemia

RBCs leak K+ after 30 mins

haemolysis - high RBC K+ content

thrombocytosis - secrete K+ in clotting

leukocytosis

what is teh other name for hyperaldosteornism

conn’s syndrome

what cuases it

neoplasia

hyperplasia

zona glomerulosa

presnetation

cervical ventroflexion due to hypokalaemia

muscle weakness

hypertension

metabolic alkalosis due to hypokalaemia but mild

low phopshate and magnesium

higher CK

how to diagnose (2)

low potassium but high aldosterone

high aldosterone but low renin