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Medical: 5 Endocrinology: 4

  • A.

    Epidemiology

    • 1.

      Incidence

    • 2.

      Mortality/ morbidity

    • 3.

      Risk factors

    • 4.

      Prevention strategies

  • B.

    Pathophysiology

    • 1.

      A spectrum of clinical abnormalities caused by an excess of corticosteroids, especially glucocorticoids

    • 2.

      Causes

      • a.

        Corticotropin secreting pituitary tumor

      • b.

        Cortical secreting neoplasm within the adrenal cortex

      • c.

        Excess secretion of corticotropin by a malignant growth outside the adrenal

      • d.

        Prolongs administration of high dose corticosteroids

  • C.

    Assessment

    • 1.

      History

    • 2.

      Signs and symptoms

      • a.

        Thinning hair

      • b.

        Acnes

      • c.

        Hump on back of neck (buffalo hump)

      • d.

        Supraclavicular fat pad

      • e.

        Thin extremities

      • f.

        Ecchymosis

      • g.

        Slow healing

      • h.

        Pendulous abdomen

      • i.

        Weight gain

      • j.

        Increased body and facial hair

  • D.

    Management

    • 1.

      Airway and ventilation

    • 2.

      Circulation

    • 3.

      Pharmacological interventions

    • 4.

      Non-pharmacological interventions

    • 5.

      Transport consideration

      • a.

        Appropriate mode

      • b.

        Appropriate facility

    • 6.

      Psychological support/ communication strategies

  • V.

    Adrenal insufficiency - Addison's disease

    • A.

      Epidemiology

      • 1.

        Incidence

      • 2.

        Mortality/ morbidity

      • 3.

        Risk factors

      • 4.

        Prevention strategies

    • B.

      Pathophysiology

      • 1.

        Adrenal insufficiency

        • a.

          Adrenal steroids are reduced

          • (1)

            Glucocorticoids

          • (2)

            Mineralocorticoids

          • (3)

            Androgens

      • 2.

        Most common cause is idiopathic atrophy of adrenal tissue

      • 3.

        Less common caused include hemorrhage, infarctions, fungal infections and acquired

United States Department of Transportation National Highway Traffic Safety Administration Paramedic: National Standard Curriculum

12

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