Activity 1 Metabolism And Thyroid Hormone

Using the movie “Once Were Warriors” as 3 different clients, how would you write a full diagnosis based on their medical conditions?

3. List and define each of the patient’s additional symptoms in your own words. These terms appear

Cushing 's syndrome (CS) is characterized by pathologically elevated free glucocorticoid levels. Endogenous hypercortisolism is usually due to ACTH-secreting pituitary corticotropic adenomas and less often due to ectopic ACTH-secreting neuroendocrine neoplasms or ACTH-independent adrenal cortisol hypersecretion (Yaneva, 2010). Cushing 's disease occurs infrequently in an inherited setting in both of these conditions (Yaneva, 2010).

It is important to teach diabetic patients or those who are at risk to watch carbohydrate intake because that directly influences glucose levels. Non-animal sources of protein such as legumes and whole grains should be consumed. High fiber is recommended, specifically soluble fiber such as lentils, oats, grapefruits, broccoli, beans or brussel sprouts. Teach the patient that alcohol consumption can cause

4. The symptoms the client described that were consistent with the diagnosis. Describe at least 2 symptoms from the diagnostic criteria.

1. Cushing's disease is a hormonal disorder which is caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol. It is sometimes referred to as hypercortisolism, it is fairly rare and it most commonly affects adults between the ages of 20 to 50. There is an estimated 10 to 15 of every million people who are affected every year.

In order to gain insight on the most frequently seen healthcare problem, I chose to interview a registered nurse from Georgia Regents Medical Center, Mrs. Denead Buoy RN, MSN. I chose this medical provider because she has had experience in her field for 17 years. During the interview, I gained valuable information about a disease that she stated she sees commonly in her in patient unit. The disease she noted was diabetes mellitus. During the interview she gave me information about the disease in terms of its causes, its frequency, and the reason she decided to identity these disease.

It is important to distinguish between Cushing disease and Cushing syndrome. While both are based on high levels of cortisol circulating in the body, Cushing disease is specifically caused by a generally benign tumor of the pituitary gland which secretes excess levels of adrenocorticotropic hormone (ACTH), leading to overproduction of cortisol in the adrenal glands. Cushing syndrome, on the other hand, refers to the symptoms caused by elevated levels of cortisol in the body due to any cause, and is also called hypercortisolism or hyperadrenocorticism. In addition to the Cushing disease promoting pituitary tumor, a number of additional circumstances may lead to the development of Cushing Syndrome. Elevated levels of cortisol often are a result of a prolonged use of corticosteroids, which may be prescribed for the treatment of allergies, asthma, or autoimmune diseases. However, elevated cortisol levels may also occur with cancerous or benign tumors of the ACTH-producing lungs, pancreas, or thyroid stimulating an excess production of cortisol. Cushing syndrome is fairly rare, affecting 10 -15

themselves are malfunctioning that is called primary adrenal insufficiency. Another reason that cortisol production is lacking might be because not enough ACTH is being generated by the pituitary gland. The second order effect of inadequate levels of ACTH being secreted results in cortisol not being produced. When this is the case it is called secondary adrenal insufficiency (MedlinePlus, 2011).

To receive a diagnosis from a doctor, he or she will conduct the following. First, a blood test will measure the levels of sodium, potassium, cortisol, and adrenocorticotropic in your blood stream. The test will tell the doctor if adrenal insufficiency may be causing the signs and symptoms a patient may be associating with. An adrenocorticotropin stimulation test will measure the level of cortisol in your blood before and after an injection of synthetic adrenocorticotropic is put into the body. If the adrenal glands are damaged, the andreocorptropic test wil will show that the cortisol in the patient 's body is limited or that there is none. The third type of test is an insulin-induced hypoglycemia test. If a doctor suspects that pituitary disease is a cause of adrenal insufficiency, he or she will perform a test involving checking blood sugar and cortisol levels at certain times after insulin is injected into

Cushing’s syndrome (also known as Cushing’s disease) is a disorder of the endocrine system. The disease is caused by the excess production, or in some cases excess consumption, of the hormone cortisol. The disease can be caused by tumors on the pituitary gland, adrenal gland complications, and the usage of corticosteroids. Cushing’s syndrome is difficult to diagnose due to its rarity, and there is no specific test to diagnose it. Symptoms of Cushing’s syndrome include obesity, “moon face”, slow growth rate, skin changes, and muscle and bone changes. Cushing’s syndrome is treatable. Some of the treatments include surgery, chemotherapy, and radiation.

“Other factors that may increase the risk of Cushing’s disease include obesity, type 2 diabetes, poorly controlled blood sugar levels and high blood pressure. While none of these factors are a direct cause of the condition, they are associated with higher prevalence of it.” (Endocrine Society, 2016) Cushing’s syndrome is most common in patients on high levels of steroid medications to treat chronic inflammatory disorders. (Williams, L., & Hopper, P., 2015)

Serum cholesterol rates have been the most reliable means of predicting remission after pituitary surgery to manage Cushing's. However, this study suggests that surgery is not always the best option, and often results in a cyclic form of hypercortisolism.

The hormonal disorder, Addison’s disease (also know as Hypoaldosteronism) occurs when the Adrenal Glands are damaged, therefore making it incompetent to produce adequate amounts of aldosterone. Generally, Addison’s disease is caused by an autoimmune response (when the body damages its own tissues) to the adrenal glands, however there are other causes including; cancer, infection or surgical removal of particular tumours within the adrenal, pituitary glands or hypothalamus. Symptoms of this disease develop gradually, such symptoms include; fatigue, salt cravings, dehydration or dizziness.

A medical history is very important if the patient has any symptoms mentioned above, especially hyperpigmentation of the skin or gums, it is often enough to raise a strong suspicion, prompting the appropriate tests. The following tests are appropriate to order to diagnose adrenal insufficiency: Serum chemistry, abnormalities are present in as many as 56% of patients. Hyponatremia is common although not diagnostic; hyperkalemia, metabolic acidosis, and hypoglycemia also may be present. However, the absence of laboratory abnormalities does not exclude the diagnosis of adrenal crisis. Serum cortisol, less than 20 mcg/dL in severe stress or after ACTH stimulation is indicative of adrenal insufficiency. ACTH test which is diagnostic, determine baseline serum cortisol, then administer ACTH 250 mcg intravenous push (IVP), and then draw serum cortisol 30 and 60 minutes after ACTH administration. An increase of less than nine mcg/dL is considered diagnostic of adrenal insufficiency. CBC, anemia mild and nonspecific, lymphocytosis, and eosinophilia highly suggestive may be present. Serum thyroid levels, assess for