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The document discusses various endocrine causes of secondary hypertension, including pheochromocytoma, primary hyperaldosteronism, and Cushing's syndrome. Pheochromocytomas are rare tumors that produce catecholamines and can cause paroxysmal hypertension, headaches, sweating, and palpitations. Primary hyperaldosteronism is often caused by an aldosterone-producing adenoma or bilateral adrenal hyperplasia, and results in hypertension and hypokalemia. Cushing's syndrome is characterized by hypercortisolism and causes central obesity, hypertension, glucose intolerance, and other symptoms. Diagnosis of endocrine causes involves biochemical and imaging tests.
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Endocrine hypertension
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Endocrine hypertension
This document discusses various endocrine causes of hypertension. Adrenal causes include pheochromocytoma, primary aldosteronism, congenital adrenal hyperplasia, apparent mineralocorticoid excess, and Cushing's syndrome. Thyroid disorders like hyperthyroidism and hypothyroidism can also cause hypertension. Other endocrine conditions that may increase blood pressure include primary hyperparathyroidism and acromegaly. The treatment for endocrine hypertension involves treating the underlying endocrine disorder through medications, surgery, or other therapies.
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The document discusses endocrine hypertension and provides an overview of the endocrine system and what high blood pressure and prehypertension are. It defines hypertension and discusses classifications of blood pressure. It notes that hypertension has no cure but can be prevented and managed. It provides prevalence statistics and discusses types of hypertension including primary, secondary, essential, and idiopathic hypertension. It describes some specific causes of secondary hypertension like pheochromocytoma, aldosterone, Cushing's syndrome, and renal issues. It outlines the renin-angiotensin system and discusses management of hypertension through lifestyle changes and drug treatments.Primary Hyperadosteronism
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The document discusses secondary hypertension, defining it as elevated blood pressure due to an underlying disorder. The most common causes of secondary hypertension include renal parenchymal diseases, primary aldosteronism, Cushing's syndrome, pheochromocytoma, and renovascular hypertension. It provides details on the definition, causes, signs and symptoms, diagnostic tests, treatment options, and prognosis for each of these common causes of secondary hypertension.
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This document provides an overview of secondary hypertension workup. It discusses that secondary hypertension accounts for 5-10% of cases and can be curable. Testing requires a high index of clinical suspicion, such as new onset hypertension under 30 or over 50 years old, or hypertension refractory to 3 or more medications. Routine tests include a urinalysis, blood tests, ECG, and tests for renal, renovascular, adrenal, and thyroid causes. Specific signs or symptoms that should raise suspicion for an underlying secondary cause include hypokalemia without diuretic use, epigastric bruits, differential blood pressures between arms, and episodic hypertension, flushing and palpitations.
secondary hypertention
Secondary hypertension is high blood pressure caused by an underlying medical condition rather than essential or primary hypertension, which has no clear cause. It can be caused by kidney, artery, heart, or endocrine system diseases. To diagnose secondary hypertension, doctors perform blood and urine tests, ultrasounds, and ECGs to check for conditions that may be raising blood pressure levels. Identifying and treating the underlying condition is important to manage secondary hypertension risks like organ damage, heart failure, and stroke.
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The document discusses secondary hypertension, defining it as elevated blood pressure due to an underlying disorder. The most common causes of secondary hypertension include renal parenchymal diseases, primary aldosteronism, Cushing's syndrome, pheochromocytoma, and renovascular hypertension. It provides details on the definition, causes, signs and symptoms, diagnostic tests, treatment options, and prognosis for each of these common causes of secondary hypertension.
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This document provides an overview of secondary hypertension workup. It discusses that secondary hypertension accounts for 5-10% of cases and can be curable. Testing requires a high index of clinical suspicion, such as new onset hypertension under 30 or over 50 years old, or hypertension refractory to 3 or more medications. Routine tests include a urinalysis, blood tests, ECG, and tests for renal, renovascular, adrenal, and thyroid causes. Specific signs or symptoms that should raise suspicion for an underlying secondary cause include hypokalemia without diuretic use, epigastric bruits, differential blood pressures between arms, and episodic hypertension, flushing and palpitations.
secondary hypertention
Secondary hypertension is high blood pressure caused by an underlying medical condition rather than essential or primary hypertension, which has no clear cause. It can be caused by kidney, artery, heart, or endocrine system diseases. To diagnose secondary hypertension, doctors perform blood and urine tests, ultrasounds, and ECGs to check for conditions that may be raising blood pressure levels. Identifying and treating the underlying condition is important to manage secondary hypertension risks like organ damage, heart failure, and stroke.
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1. Secondary hypertension accounts for 5-20% of hypertension cases and has an identifiable underlying cause. Common causes include renal parenchymal disease, renovascular hypertension, primary aldosteronism, Cushing's syndrome, pheochromocytoma, and coarctation of the aorta.
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Pheochromocytoma is a rare tumor that secretes catecholamines like norepinephrine and epinephrine. It can cause dangerous spikes in blood pressure during surgery if not properly managed. The document discusses:
1. The diagnosis of pheochromocytoma involves urine or plasma tests to detect elevated catecholamines and imaging like MRI to locate the tumor.
2. Preoperative management aims to block catecholamine effects using long-acting alpha blockers like phenoxybenzamine for 2 weeks before adding beta blockers to control blood pressure surges during surgery.
3. Complete surgical removal of the tumor is the definitive treatment but careful management of blood pressure is vital due to risks
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This document discusses pituitary gland disorders and anesthetic management. Key points include:
1. Pituitary tumors can cause hormonal imbalances and compression of surrounding structures, requiring careful perioperative management.
2. Patients may have hypopituitarism requiring steroid supplementation or acromegaly/Cushing's disease resulting in distinctive physical features and comorbidities.
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TO THE SOUL OF THE PEOPLE WHO DREAMS BETTER DAYS AND PERFECT FUTURE WHO DIED THINKING THAT LIBYA IS WORTHY NOT THE LIBYAN
HOPPING OUR ALLAH ACCEPT THIS SMALL WORK
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-Sự giống nhau và khác nhau của suy thượng thận tiên phát và thứ phát.
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Secondary hypertension by dr Raj kishor
1. Secondary hypertension accounts for 5-20% of hypertension cases and has an identifiable underlying cause. Common causes include renal parenchymal disease, renovascular hypertension, primary aldosteronism, Cushing's syndrome, pheochromocytoma, and coarctation of the aorta.
2. Renal disease is the most common cause of secondary hypertension. Renovascular hypertension, usually caused by atherosclerosis or fibromuscular dysplasia, can lead to renal artery stenosis and impaired renal function.
3. Other hormonal causes include primary aldosteronism, characterized by excessive aldosterone secretion leading to hypokalemia, and Cushing's syndrome, where excess cort
Hpofunction of adrenal cortex
re-view of physiology of adrenal cortex. congenital adrenal hyperplasia. Disorder of adrenocortical insufficiency - primary and secondary adrenocortical insufficiency.pathology of primary insufficiency. hypoaldosteronism. ACTH stimulation test.
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2. Case 1 involves a 25-year-old male with high blood pressure found on a pre-employment checkup, prompting evaluation for secondary causes of hypertension.
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The document discusses pheochromocytoma, a rare tumor of the adrenal glands that secretes excess catecholamines. It causes high blood pressure, headaches, increased heart rate and metabolic changes. Diagnosis involves testing urine and plasma catecholamine levels. Treatment includes alpha-blockers to lower blood pressure before surgery to remove the tumor. Nursing care focuses on monitoring vital signs and blood pressure to prevent hypertensive crises before and after surgery.
Pheochromocytoma Anesthesia
Pheochromocytoma is a rare tumor that secretes catecholamines like norepinephrine and epinephrine. It can cause dangerous spikes in blood pressure during surgery if not properly managed. The document discusses:
1. The diagnosis of pheochromocytoma involves urine or plasma tests to detect elevated catecholamines and imaging like MRI to locate the tumor.
2. Preoperative management aims to block catecholamine effects using long-acting alpha blockers like phenoxybenzamine for 2 weeks before adding beta blockers to control blood pressure surges during surgery.
3. Complete surgical removal of the tumor is the definitive treatment but careful management of blood pressure is vital due to risks
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This document discusses disorders of the adrenal cortex, including Conn's syndrome (primary hyperaldosteronism), Cushing's syndrome, and Addison's disease. It covers the anatomy and physiology of the adrenal glands, pathophysiology of the disorders, clinical presentations, diagnostic evaluations, and perioperative anesthetic management considerations for patients with these conditions. Surgical treatment may be needed for adrenal adenomas in Conn's syndrome and Cushing's syndrome, requiring careful perioperative management of hypertension, electrolyte abnormalities, and hemodynamic instability.
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This document discusses Cushing's syndrome, which results from chronic exposure to excess glucocorticoids. It can be ACTH-dependent or independent. The most common cause is Cushing's disease, caused by a pituitary corticotrope adenoma. Establishing the diagnosis requires clinical evaluation and investigations to determine if it is ACTH-dependent or independent and the nature of any adrenal or pituitary pathology. A combination of screening tests is used, and imaging helps locate the source of excess corticosteroids for appropriate treatment.
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Secondary hypertension can be caused by renal or endocrine disorders. Renal causes include renal parenchymal diseases like glomerulonephritis which account for 2-5% of secondary hypertension cases. Renovascular hypertension from atherosclerosis or fibromuscular dysplasia is responsible for 1-3% of cases. Primary aldosteronism is an uncommon but important endocrine cause that can present with hypokalemic hypertension and is diagnosed through elevated aldosterone to renin ratio and saline suppression testing. Imaging and adrenal vein sampling are used to determine unilateral vs bilateral disease.Pituitary gland disorders and anesthetic management
This document discusses pituitary gland disorders and anesthetic management. Key points include:
1. Pituitary tumors can cause hormonal imbalances and compression of surrounding structures, requiring careful perioperative management.
2. Patients may have hypopituitarism requiring steroid supplementation or acromegaly/Cushing's disease resulting in distinctive physical features and comorbidities.
3. Anesthesiologists must consider each patient's specific hormonal status and tumor effects when planning airway management and hemodynamic support for pituitary surgery.
Endocrine emergencies
The most common endocrine emergencies are diabetic emergencies such as diabetic ketoacidosis (DKA) and hypoglycemia. Other less common but life-threatening emergencies include adrenal crisis, thyroid storm, hypoparathyroidism-related hypocalcemia, and pheochromocytoma. It is important to consider the diagnosis, triggers, and follow treatment protocols to stabilize the patient and address the underlying condition.
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TO THE SOUL OF THE PEOPLE WHO DREAMS BETTER DAYS AND PERFECT FUTURE WHO DIED THINKING THAT LIBYA IS WORTHY NOT THE LIBYAN
HOPPING OUR ALLAH ACCEPT THIS SMALL WORK
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The document provides information on the management of hypertensive crisis. It begins with outlines of topics covered which include introduction, etiology, pathophysiology, clinical evaluation, workup, and management. It then goes into further detail on these topics. The key points are:
1) Hypertensive crisis is defined as a sudden rise in blood pressure that causes end organ damage and is classified as either a hypertensive urgency or emergency.
2) Common causes include poorly controlled essential hypertension and renal disease.
3) Rapid evaluation is needed to identify end organ damage to the heart, kidneys, brain, or vasculature.
4) Treatment involves slowing lowering blood pressure, usually over hours
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This document summarizes the pathophysiology of chronic hypertension with superimposed preeclampsia in a 42-year-old patient. Activation of the sympathetic nervous system and endothelial damage causes widespread vasoconstriction and reduced uterine and placental blood flow. This leads to elevated blood pressure, headaches, dizziness, vomiting, muscle weakness on the left side of the body, and difficulty sitting without support. Abnormal clotting occurs due to vasospasms and increased peripheral resistance. Elevated blood pressure can compress the brain and cause an acute cerebellar hemorrhage. Increased aldosterone and angiotensin levels lead to sodium and water retention and further arteriolar vasoconstriction
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This presentation discusses adrenocortical hypofunction, specifically focusing on primary and secondary adrenal insufficiency. It begins by outlining the learning objectives and providing definitions. It then describes the causes, signs and symptoms, diagnosis, and treatment of primary adrenal insufficiency, including Addison's disease and crisis. Secondary adrenal insufficiency is explained as resulting from hypothalamic-pituitary dysfunction. Treatment involves replacing glucocorticoids and mineralocorticoids through medications like hydrocortisone and fludrocortisone.
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- A 55-year-old male presented with 3 weeks of weakness, fatigue, and weight loss. Physical exam found him to be thin and lean with oral pigmentation.
- Labs found leukopenia, a positive PPD test, low cortisol, increased ACTH, and a normal chest x-ray.
- The final diagnosis was tuberculosis adrenalitis, which had caused primary adrenal insufficiency.
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This document discusses three patient cases presenting with resistant hypertension. Case 1 involves a 49-year-old female with obesity and resistant hypertension who shows signs of primary aldosteronism based on blood tests. Case 2 is a 53-year-old female with a 10-year history of resistant hypertension, low potassium levels, and imaging showing a lesion on her left adrenal gland. Case 3 is a 55-year-old male with resistant hypertension and normal potassium who was confirmed to have primary aldosteronism based on salt loading tests, but no adrenal lesion was seen on imaging. All three patients underwent adrenal vein sampling to further evaluate their condition.
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Secondary adrenal insufficiency
-Sự giống nhau và khác nhau của suy thượng thận tiên phát và thứ phát.
-test đanh giá sự toàn vẹn của trục đồi-yên-thượng thận
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This document discusses the anatomy, physiology, and pathological disorders of the adrenal glands and their management during anaesthesia. It describes the adrenal cortex and medulla, hormone production and regulation. Pathologies covered include Cushing's syndrome, Conn's syndrome, hypoaldosteronism, and primary/secondary adrenal insufficiency. Perioperative management focuses on fluid/electrolyte balance, stress dosing of steroids, and monitoring for adrenal crises. Determining return of normal adrenal function and intensive care management are also outlined.
Adrenal insufficiency
Adrenal insufficiency, also known as Addison's disease, is caused by destruction of the adrenal cortex leading to deficiencies in glucocorticoids and mineralocorticoids. It presents with non-specific symptoms like fatigue, weight loss, and low blood pressure. Diagnosis involves low cortisol levels in response to ACTH stimulation and high ACTH levels. Treatment is lifelong glucocorticoid and mineralocorticoid replacement. An adrenal crisis can result from infection or stress and requires immediate high dose glucocorticoid treatment in addition to intravenous fluids and glucose to prevent shock.
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Phaeochromocytoma
A 29-year old man presented to the emergency room with crushing headaches and palpitations. Pheochromocytoma is a rare neuroendocrine tumor that secretes catecholamines and can cause hypertension. It arises from chromaffin cells of the adrenal medulla. Diagnosis involves urine or plasma tests to detect elevated catecholamines and imaging studies like MRI or MIBG scan to locate the tumor. Surgical removal is the primary treatment, along with pre-operative medication to control blood pressure. Lifelong monitoring is needed due to risk of recurrence.
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This document discusses endocrine disorders of the adrenal gland. It covers conditions such as Cushing's syndrome, congenital adrenal hyperplasia, hyperaldosteronism, and adrenal insufficiency. Cushing's syndrome is caused by excess cortisol and can be ACTH-dependent or -independent. It presents with central obesity, moon facies, buffalo hump, and purple striae. Tests include urine cortisol and low-dose dexamethasone suppression. Treatment depends on the cause but may include surgery or medication. Primary adrenal insufficiency involves deficiencies of both glucocorticoids and mineralocorticoids.
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This document discusses the diagnosis and management of pheochromocytoma. Key points include:
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Burns
MRS.C.MARY LALITHA KALA
ASSOCIATE PROFESSOR, MEDICAL AND SURGICAL NURSING
ANRI COLLEGE OF NURSING
VISAKHAPATNAM
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1. A 40-year-old man presented with cough, swelling of the lower limbs and abdomen, and shortness of breath. Examination found signs of right heart failure and rapid atrial fibrillation.
2. Further history revealed symptoms of hyperthyroidism. Tests confirmed Graves' disease.
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This document provides an overview of the endocrine system and various endocrine glands and hormones. It discusses the anatomy and physiology of key glands like the pituitary, thyroid, parathyroid, adrenal and pancreas. It also presents several case studies relating to disorders of these glands, such as Cushing's syndrome, Graves' disease, hypothyroidism, hyperparathyroidism, and diabetes mellitus. The document aims to discuss endocrine diseases, their treatments, and associated complications.
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This document discusses the immunologic basis of allergic disease. It describes the primary, secondary, and tertiary responses of the host's immune system and how these responses can be either beneficial through immunity or harmful through causing allergies. It outlines the various cells and mediators involved in allergic inflammation, including mast cells, basophils, eosinophils, cytokines, histamine, leukotrienes and others. It also summarizes several common allergic diseases like allergic rhinitis, asthma, atopic dermatitis, urticaria, food allergy and contact dermatitis.
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This document discusses the clinical approach to diagnosing congenital heart disease. It provides statistics on the incidence of CHD and notes it occurs in 6 per 1000 live births for moderate/severe forms. A clinical diagnosis of CHD requires accurate observations and logical inferences. CHD is classified based on whether cyanosis is present, pulmonary blood flow, the side of the heart affected, and whether pulmonary hypertension is present. The diagnosis involves considering the patient's history, physical exam findings, chest x-ray, and ECG.
Atls tenth ed initial mm
- Trauma is a leading cause of death worldwide, with injuries from motor vehicle accidents being a top cause. Hemorrhage accounts for about 50% of trauma deaths within hours of injury.
- The goals of trauma management are to secure the airway, control bleeding through fluid resuscitation and blood product transfusion, and treat for shock. Permissive hypotension aims to limit fluid administration to avoid disrupting clots until bleeding is controlled.
- Early identification and treatment of hemorrhage is critical to preventing death, and strategies like damage control resuscitation focusing on blood product administration over crystalloids can improve outcomes for severely injured patients.
rheumatic heart disease and fever INDIA
This document discusses rheumatic heart disease (RHD) and rheumatic fever (RF) globally and in India. It finds that RHD prevalence is highest in India, at 5-11 cases per 1000 people aged 5-15. India has over 1 million RHD cases, accounting for 20-30% of cardiovascular disease hospital admissions. RF most commonly causes heart disease in people aged 5-30. Globally there are 15.6 million RHD cases, with 282,000 new cases and 233,000 deaths each year. Echocardiography can help diagnose RF early and monitor RHD status to determine appropriate treatment. Prevention relies on prompt treatment of streptococcal throat infections with antibiotics.
Tetnus by dr balwant
- The patient is a 45-year-old male shopkeeper who presented with a history of road traffic accident 3 days prior where he sustained a left tibia and fibula fracture.
- He developed fever, abdominal tenderness, and lockjaw. Examination found decreased consciousness, hemiparesis, upgoing plantars, and coarse lung sounds.
- Investigations confirmed aspiration pneumonia, septicemia, and tetanus. The patient was diagnosed and treated for head injury, tetanus, aspiration pneumonia, and septicemia. Management included antitetanus serum, antibiotics, anxiolytics, and supportive care.
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Preparation of a patient of obstructive jaundice and periampullary carcinoma
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