Protein Steroid Management Of Patients With A Normal Hypothalamic Pituitary Axis Essay

The patient is a 59-year-old right-handed white female who was admitted in June to Portsmouth Regional Hospital for what was determined to be either transient global amnesia or complicated migraine. I did review those notes. She was seen by Galina Simkin, MD. The symptomatology discussed in the H&P is consistent with transient global amnesia. She was having problems asking questions inappropriately, repeating sentences, repeating questions over and over again, and seeming somewhat confused. There were no other neurological symptoms at that time. No evidence for seizure activity. No evidence for stroke. She was brought to the emergency room, where she underwent a CAT scan, which was

*Endocrine glands produce – hormones, they work with other hormones to perform many functions including: control water & electrolyte balance, regulating carbohydrate metabolism, working as neurotransmitters, maintaining stress & inflammation, regulate reproductive functions

Mr. S is a 29-year-old male with past medical history of (PMH) hypertension (HTN) and obesity who presented to local emergency room (ER) with headache and chest and back pain. Mr. s had been seen at urgent care three days prior for a headache and near syncope and was told to hold his metoprolol due to bradycardia. Due to health insurance related problem, he has been off amlodipine and lisinopril for a month.

“The patient is Adam Rudd, a 78 y/o white male with a history of hypertension. He has been diagnosed with hypertension past 15 years and is on anti-hypertensive medications and aspirin. He is very weak and short of breath. He is accompanied with his longtime friend Jennifer, who reports that Rudd was looking very weak and was complaining of severe headache and blurred vision before coming to the hospital. He is 5’9” and weighs 270 lb. Vital signs recorded were: oral temperature 98.20 F, BP 224/120 mm Hg with a heart rate of 102 beats/minute and respiration of 24 breaths per minute. The pulse oximetry reading was 94% on room air. He is complaining of severe headache and blurred vision. Rudd said that he did not take his antihypertensive medication or aspirin since he ran out of pills. He has not been taking his medication for past 15 days. He reports no known allergies to any medications or other substances.”

He also had right more than left mastoid opacifications and states that he was recently treated for otitis media. He has hypertension, hyperlipidemia, coronary disease and had been noncompliant with his medications in the past. His exam was essentially normal except for the subjective vertigo. There was no nystagmus and no diplopia on the initial exam. On 06/19/2015, he gave a different history. He states that he had a strike to the left temporal on Tuesday 06/16/2015. This did not result in any vertigo or any other neurological symptoms at that time. It was two days later that he had the vertigo at work. The patient also claimed that he had been seeing double since the previous night and the morning of the 19th. However, his neurological exam at that time, failed to reveal any actual disconjugate gaze. The patient had an MRI MRA, which revealed old white matter ischemic disease and mild intracranial atherosclerosis, but no evidence for acute stroke or posterior circulation significant stenosis. His diagnosis was labyrinthitis, possibly due to his bilateral mastoiditis. He was treated with Augmentin for 10 days. His symptoms resolved prior to discharge on meclizine. On physical therapy on discharge, he had no

An acute presentation of hypertension will present with the aforementioned hemorrhages and exudates due to the bursting of small vessels. When the degree of hypertension is of a high severity, blurry vision and papilledema can also develop due to optic nerve infarction or increased intracranial pressure, respectively. Meanwhile, a chronic presentation will look quite different. A chronic pattern of hypertension will not involve papilledema, but instead will include arterial vasoconstriction and sclerosis. The “copper wiring” that was present in our patient’s case this week arises from this sclerosis. The appearance occurs because of an increased reflection of light while performing the fundoscopic exam

Blood pressure -138/88, HR 71, Lung sounds –clear, temperature 98.8 F, radial pulse and pedal pulses +1 bi-laterally, normoactive bowel sounds. No history of smoking, drugs, alcohol use or diabetes; takes no daily medications. Surgical history: Hernia surgery September 2016 and cataract surgery September 2013. Moderately active, walks every day, sometime incorporating hand weights. Patient presents with minimal trembling unilaterally, (left side) when fingers stretched out, reports movements have been slower than normal. Patient’s wife reports “He’s been eating more slowly and it has been taking longer for him to get dressed in the morning.”. Upon examination it was determined that patient has reduced arm swing, slight stiffness in neck, difficulty rising from sitting position in the chair, masked facial features and deteriorated balance. No signs or symptoms of stroke.

The adrenal glands, located above the kidneys, are where natural hormones and steroids that the body uses are secreted and regulated. These hormones and steroids come from either the adrenal cortex, or the adrenal medulla. Hormones from the cortex start at the pituitary gland where ACTH or adrenocorticotrophic hormone is secreted. “ The adrenal cortex secretes hormones known as corticosteroids, or cortical steroids.”( Rather, Spencer) There are three zones of the adrenal cortex, the zona glomerulosa, fasciulata, and reticularis. Each of these zones produce specific steroid hormones. Two main types of steroids among many others are Cortisol and Aldosterone. Cortisol is referred to as the stress hormone as it is involved in the response to stress and anxiety. Aldosterone increases reabsorption and retention of sodium and water in the kidneys. This process involves secretion of potassium and is stimulated by low blood sodium, this increases blood volume and

For the indication provided, GHOP considers H.P. Acthar Gel not medically necessary for corticosteroid –responsive

The patient denies having any history of CNS infection or already significant systemic infections. He has never had any thunderclap headaches, or any left-sided neurological symptoms. He does recall having a marked headache during the flight in the 1980s and one recent exertion-induced headache last fall, lasting 15 minutes. Otherwise, he gets mild headaches and aches and pains for which he does occasionally take aspirin. There is no family history of aneurysms. His father did die of a brain tumor, which the patient called the primary "Astro something". It was not metastatic. The patient says his ENT is aware of the nasopharyngeal mass and has called it polyps. The patient also has history of bradycardia and occasionally when he takes his pulse and he finds that it is irregular. He has an evaluation with a cardiologist coming up to rule out atrial fibrillation. He also has a family history of what may be a benign essential tremor. His father a couple of paternal uncles had this tremor. He has had it for years. It has slowly increased over the years, but it still is intermittent to high frequency, low amplitude, mostly action

A seventeen year old male arrived at the medical facility ambulatory. The patient was in route to neurology for evaluation when he abruptly became camtose (in a state of unconsciousness or coma). Patient was observed afflicted with hemiparesis (feeling weak on one half of the body or the other) in his left side which quickly escalated to hemiplegia (loss of the ability to move half of the body). Also leading up to the coma the patient showed ataxia (lack of muscle coordination) (Gylys, 2013), and during attempts to verbally keep him conscious he was aphrasic (unable to speak). The patient’s record indicates hereditary cerebrovascular disease (any functional abnormality of the cerebrum caused by disorders of the blood vessels of the brain)

Recently, my husband is having pain on the right eye every time he is exposed to the sunlight, and he says that the pain leads to a headache on the right side of his head. He is making sense of this issue by thinking about his family history. His maternal grandfather was diagnosed with diabetic retinopathy which is "asymptomatic until it reaches an advanced and often untreatable stage but it is easily detected by retinal examination" (Ockrim & Yorston, 2010, p. 934). Unfurtunately, my husband's grandfather was diagnosed with diabetic retinopathy too late, and he lost his vision.

The pituitary gland is located in the brain at the base under the hypothalamus and is the size of a pea (BodyMaps). This gland is made up of three different sections, the anterior lobe, the intermediate lobe, and the posterior lobe (BodyMaps). Each one provides the body with various hormones which targets different internal organs. The anterior lobe sends out the following hormones: Adrenocorticotropic hormone, Thyroid-stimulation hormone, Folicile-stimulating hormone, luteinizing hormone, Prolactin, and Growth hormone (McMillan and Starr 290). These hormones help with promote the release of other hormones as well as the assist with production of the hormones for the reproductive organs such as the ovaries and testes (McMillan and Starr

Background: Our study team has examined the pituitary gland volumes in a variety of anxiety disorders which of them have been published and which of them are unpublished studies. Moving from this point, in the present study, it was aimed to investigate pituitary gland volumes picking up those subjects.

History of Present Illness: Mr. A. O. a 66 year-old-African American male came in the clinic for a monthly routine follow up visit complaining of severe cluster frontal headaches that radiates to his left eye, pain level eight out of ten, on and off for three days lasting for 30 to 45 minutes. He stated that he takes Tylenol 1000mg orally every eight hours with mild relieve, and will like his blood pressure medications increased. Also, he complained of edema to the upper and lower extremities, and right hand pain when he tries to make a fist. However, he denied shortness of breath,