Episode 277: Keywords part 26: Adrenal Diseases with Gillian Isaac
Mar 10, 2024
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Dr. Gillian Isaac discusses Adrenal Diseases for anesthesia exams, covering high-yield topics like pheochromocytoma, cushing's disease, and aldosteroneism. The conversation includes adrenal cortex physiology, hormone synthesis, lab findings, and treatment strategies. Also, exploration of hormonal functions, diagnostic testing, clinical conditions, symptoms, and medication considerations. Plus, random recommendations for books and podcasts at the end.
Primary hyperaldosteronism presents with hypertension but not excessive adrenal medulla hormone secretion.
Post-transphenoidal surgery patients with large urine output likely have central diabetes insipidus, not other causes like osmotic diuresis.
For perioperative steroid coverage, administer hydrocortisone at 50-75mg IV for patients with prolonged steroid therapy undergoing major surgery.
Deep dives
Primary Hyperaldosteronism Manifestations
Excess secretion of hormone from the adrenal medulla is not expected in primary hyperaldosteronism, unlike hypertension, metabolic alkalosis, and hypokalemia.
Transphenoidal Surgery Postoperative Diuresis
In the case of the patient post-transphenoidal surgery, the large urine output is likely due to central diabetes insipidus, not osmotic diuresis from mannitol or other causes like excess mineralocorticoid activity or hyperglycemia.
Adrenal Gland Steroid Recommendations
For perioperative steroid coverage, hydrocortisone is recommended at 50 to 75 milligrams IV for a patient with a history of prolonged steroid therapy undergoing major surgery.
The Killer Angels Historical Fiction Book
Consider reading 'The Killer Angels' by Michael Schurr, a historical fiction book that provides a detailed account of the Battle of Gettysburg from the perspectives of various generals, offering insights into the Civil War's pivotal moment.
Arnold Schwarzenegger Interview and Smartless Podcast
Listen to Arnold Schwarzenegger's interview on the Smartless podcast, where he discusses his career, including insights into the movie 'Twins' and his transition from acting to politics.
In this 277th episode I welcome Dr. Gillian Isaac back for another ABA keyword episode. We discuss Adrenal Diseases and the questions you're likely to see about them on your exams.