Malignant Mesothelioma Case Study

The mineralocorticoid (aldosterone) is normally released by the adrenal cortex in response to decreased sodium and increased pottasium levels; the hormonally acts to promote the retention of Na and the excretion of K. It isn't working; hence the abnormal serum levels.

Paragangliomas are rare neuroendocrine tumors that arise from the extra-adrenal autonomic paraganglia, small organs consisting mainly of neuroendocrine cells that are derived from the embryonic neural crest and have the ability to secrete catecholamines (1). They are closely related to pheochromocytomas, which are sometimes referred to as intra-adrenal paragangliomas (2). The majority appear to be sporadic, but approximately one-third to one-half are associated with an inherited syndrome (3, 4). The four genetic syndromes that are associated are: multiple endocrine neoplasia 2A and 2B, neurofibromatosis type 1, von Hippel Lindau, and the Carney-Stratakis dyad. The male-to-female ratio is approximately equal among patients with hereditary paraganglioma,

The other hormone that can be affected if diagnosed with Addison 's disease is aldosterone. Aldosterone belongs to a class of hormones known as mineralocorticoids. Aldosterone is used to maintain blood pressure and water and salt balance in the body by helping the kidney retain salt or release potassium (MedicineNet, 2011). If the aldosterone levels fall too low the kidneys are unable to regulate sodium and water levels that result in a drop of blood volume and blood pressure.

Aldosterone is the mineralocorticoid steroid which is release from the adrenal gland, situated superior to the kidney. Aldosterone play a major role for the retention of water and sodium in the nephrone (10) in the patient with congestive heart failure, cirrhosis, and nephrotic syndrome (25). The level of the Aldosterone will increase in the patient of heart failure when angiotensin I receptors is activated by Angiotensin II leading to fluid overload (10).

lungs, stomach, heart and other organs. The causes of Mesothelioma are if you have been exposed to asbestos. If diagnosed with Mesothelioma symptoms that will occur are coughing, chest pain, shortness of breath, SV40 (Or Simian Virus).

“The pituitary adenoma itself may put pressure on the remaining normal part of the pituitary gland and limit or destroy its ability to produce hormones appropriately” (Stewart & Vance). With the increase in tumor pressure the patient may experience nausea and vomiting. The pituitary adenoma may cause body hair loss, sexual dysfunction, increase frequency and increase amount of urination. The pituitary adenoma is growth hormone secreting tumor causing the hands and feet to enlarge (www.mayoclinic.org). A growth hormone adenoma is the reason for the unexplained weight gain and the change in shoe size from 10 to 12.

Manifestations of peritoneal mesothelioma can incorporate swelling or agony in the stomach area, sickness and retching and an adjustment in gut propensities. Peritoneal mesothelioma can likewise bring about night sweats, fever, unexplained weight reduction, frailty, weakness and bumps under the skin of the mid-region. Manifestations of peritoneal mesothelioma create because of the thickening of the peritoneal film and liquid development between the film layers. This can put weight on the mid-region and its organs, creating the patient to experience side effects of peritoneal

At present greater than 100 chemotherapy medications are available nevertheless simply a few have proven to be befitting combating mesothelioma. Normally, medical professionals the treatment of mesothelioma affected individuals suggest mixture treatments - your conjunction utilization of 2 diverse chemotherapy medications. These combination's are actually proven to be probably the most effective with the treatment of your

Although not all TDH’s are promptly diagnosed, they can still be managed effectively once discovered. This

E.P. is an 88-year-old Caucasian male. He was admitted on 02/18/13. His code status is full code, and he declines to bring in his advanced directive. He reports that he is 68.5” tall, and his actual weight is 165 pounds. He and his wife are the sources of information, and they are reliable. His blood pressure is 124/62, taken on his right arm in a lying position, his oral temperature is 99.8, his right radial pulse is 74 beats per minute, his respiration rate is 16 breaths per minute and his pulse oximetry reading is 92 on room air. He is allergic to latex, cephalexin and sulfa drugs, with a reaction of hives, and to IV dye, with a reaction of moderate rash. He was

1. The first way in which this patient’s fluid balance is altered is by the presence of vomiting noted by the emergency department. Vomiting can cause a significant loss of electrolytes as well. The patient also has a fever of 102.3, which has probably caused some heat release by sweating leading to fluid loss. The doctor notes the patient is breathing quickly which indicates he may be losing fluid through hyperventilation. The large quantity of alcohol consumed by this patient also contributes to the alteration of fluid balance by inhibiting the pituitary gland from secreting anti-diuretic hormone (ADH) which acts directly on the kidneys to reabsorb water. When ADH levels are reduced, the kidneys produce more urine resulting in an increased

Endogenous Cushing’s syndrome results when the high levels of cortisol originate from within the body. The most common causes of endogenous Cushing’s syndrome are adrenal, pituitary or ectopic tumours. These tumours lead to a disruption of the normal functioning of the HPA axis. Exogenous Cushing’s syndrome results when the high levels of cortisol in the blood is a direct result of some factor outside of the body, such as the administration of therapeutic steroids (Bronstein 2011). The endogenous component of Cushing’s syndrome can be further broken down into ACTH dependent and ACTH independent. ACTH-dependent causes account for the majority of cases (80%) (Bronstein 2011). Pituitary adenomas account for 80% of ACTH-dependent causes, with the remaining 20% resulting from ectopic tumours. These ectopic tumours are generally small-cell carcinomas of the lungs, but may also result from endocrine tumours on a variety of organs (Newell-Price et al. 2006). ACTH-independent causes typically result from various tumours on the adrenal glands, resulting in the direct secretion of cortisol into the blood. In extremely rare cases, ACTH-independent Cushing’s syndrome can be caused by corticotropin-independent macronodular adrenal disease and McCune-Albright syndrome (Newell-Price et al. 2006).

(Medscape) All ages can be affected but those between twenty and fifty are the most commonly affected. (Mayo Clinic) These rare tumors can either secrete hormones continuously or just sometimes. They primarily occur with “certain familial syndromes”. (Medscape) These autosomal dominant syndromes include two types of “multiple endocrine neoplasia, von Hippel-Lindau disease, and Von Recklinghausen disease”. (Medscape) Norepinephrine is the predominant catecholamine released. (Medscape) The increased blood pressure and cardiac contractibility is directly caused by alpha-adrenergic receptor stimulation, whereas the increased heart rate is caused by beta-adrenergic receptor stimulation (Medscape) The release of catecholamine’s is not caused be neural stimulation in these tumors and it has been stated that is it unknown what triggers the release. (Medscape) The tumors are encapsulated, vascularized and appear reddish brown. Figure 1 is an image of a pheochromocytoma tumor.

Cases of hypercalcemia can be further broken down into those that are PTH-dependent and PTH-independent (parathyroid hormone). PTH is usually elevated in physiological conditions when there is a drop of calcium in the blood and then returns to baseline once it corrects the problem. This is not the case however in hyperparathyroidism. Furthermore, PTH-related peptide (PTHrP), which is capable of acting on PTH receptors is abnormally elevated in certain cancers such cancers of the genitourinary tract and

Etomidate is an imidazole derivative similar to Ketoconazole that inhibits both 11α-hydroxylase as well as an inhibitor of 17α-hydroxylase. According to Wells and DiPiro, it is only available in a parenteral formulation and thus its use is limited to patients with acute hypercortisolemia requiring emergency treatment. In addition, in the treating of Cushing’s syndrome Etomidate serves as an intravenous alternative to Ketoconazole. According to Chandler and Batjer, Most investigators to date have analyzed its use in hospitalized patients with neoplasms secreting ACTH. In one study in which the authors used it at a nonsedating dose of 0.3 mg/kg/hour, it normalized serum cortisol levels within 12 hours in six patients with Cushing disease. The