Clinical lecturer Author Acute Illness Management; Clinical Assessment Dedicated 2 advancement of clinical practice! #FOAMed #TweetAnatomy respect 4all always!
Manchester
Joined June 2012
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@AddisonsUK can be #life threatening if it is not recognised & treated quickly
Good news: lifesaving treatment is quick & effective 💉
#TweetAnatomy on #InternationalAddisonsDay MCQs about this condition 4 @WeParamedics @WeNurses @RCNStudents #StNProject answers later! @cpdme
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That tweet from @dianelewis6039 always raises my spirits. A person I only know in #Twitter but a person respect!
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I had to explain this a few times in the last few weeks. Here is my summary.
Tried to keep my twitter as a #covid free zone but this just needed #Clarification #Immunology
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You can find out 👀more about #Addisons Disease at:
1⃣ #NHS
nhs.uk/conditions/addisons-d…
2⃣ #NICE Guideline cks.nice.org.uk/addisons-dis…
3⃣ not forgetting @AddisonsUK addisonsdisease.org.uk/infor…
#TweetAnatomy Thanks for taking part in #InternationalAddisonsDay 🥇🏅🥇🏆 go #SaveLives
Q10: In primary adrenocortical insufficiency what effect will be seen on the #ACTH levels in the blood?
#TweetAnatomy on #InternationalAddisonsDay #Endocrine @Pituitary_org
38%Elevated
12%Normal
38%Low
12%Absent
8 votes • Final results 1
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🥇 Elevated ACTH is correct 🥇
The lack of cortisol present in the blood stimulates increased secretion of ACTH to try and return cortisol levels to normal.
Negative feedback from cortisol terminates this
#TweetAnatomy on #InternationalAddisonsDay
Q9: Hyperpigmentation of the skin is associated with which one of the following adrenocortical conditions?
#TweetAnatomy on #InternationalAddisonsDay #Endocrine @WeMedSts @AddisonsUK
58%Acute Primary
33%Chronic Primary
0%Secondary
8%Paraneoplastic
12 votes • Final results 1
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Q8: In secondary adrenocortical insufficiency the blood sodium level will most likely be?
#TweetAnatomy on #InternationalAddisonsDay #Endocrine #PhysicianAssociate #MedEd
11%Normal
72%Low
17%High
0%Labile
18 votes • Final results 1
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In secondary adrenocortical insufficiency, the cortex is healthy: the problem is it fails to receive ACTH stimulus from pituitary.
Aldosterone secretion by the adrenal is triggered by RAA System which is independent of the pituitary so no Na+ Deficiency
#TweetAnatomy
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Q7: Waterhouse-Friderichsen-Syndrome is traditionally associated with which one of the following conditions?
#TweetAnatomy on #InternationalAddisonsDay #Endocrine @WeMedSts @AddisonsUK 👀
25%Reduced prothrombin
25%Neisseria Meningitidis
50%Late HIV infection (AIDS)
0%Candidiasis
8 votes • Final results 1
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Waterhouse-Friderichsen-Syndrome is rapid failure of the adrenals as a result of bleeding into the cortex
Bacterial infection a major trigger. Neisseria Meningitidis is most synonyms
Can be another virulent organism – DIC – Sepsis.
#TweetAnatomy on #InternationalAddisonsDay
Q6: After initial treatment for an Addisonian crisis with haemodynamic instability. When should a second dose of treatment be given if required? 💉🤮
#TweetAnatomy on #InternationalAddisonsDay #Endocrine @WeNurses @AddisonsUK
12%5 mins
29%1 hour
24%6 hours
35%After Endocrine Advice
17 votes • Final results 2
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After successful treatment with Hydrocortisone reassess the person and be prepared to give a further dose of hydrocortisone at 6⃣ hours 🕕.
Don’t wait for specific endocrine advice if not immediately available, maintain stability: don’t allow a re-crisis 🚨🚨
#TweetAnatomy
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Q5: When suspected an adrenal (Addisonian) crisis should be treated with which one of the following as a priority?
#TweetAnatomy on #InternationalAddisonsDay #Endocrine #MedEd @WeParamedics @AddisonsUK
0%100mcg Fludrocortisone PO
84%100mg Hydrocortisone IM
16%10mg Prednisolone PO
0%1L of 0.9% NaCL
19 votes • Final resultsPerfect:
Hydrocortisone is the mainstay of treatment for ‘Addisonian Crisis’ give by injection to have a rapid onset & avoid being vomited back.
Fluid may also be needed to maintain BP but don’t delay hydrocortisone: IM to save time.
#TweetAnatomy on #InternationalAddisonsDay
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Q4: Secondary adrenocortical insufficiency is caused by which one of the following?
#TweetAnatomy on #InternationalAddisonsDay #Endocrine #AdvancedPractice @AddisonsUK @UHL_ClinEd
31%Pituitary adenoma
69%Lack of ACTH
0%Sarcoidosis
0%Haemorrhage
13 votes • Final results 1
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🥇That Right🏆:
📢 It’s the lack of ACTH that causes secondary adrenocortical insufficiency.
📣This said: Pituitary adenoma, Sarcoidosis & Haemorrhage into / infarction of the pituitary gland can all result in a lack of ACTH Secretion
#TweetAnatomy on #InternationalAddisonsDay
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Q3: In chronic primary adrenocortical insufficiency approximately how much of the cortical function must be impaired before the condition becomes clinically evident?
#TweetAnatomy on #InternationalAddisonsDay #Endocrine #PhysicianAssociate @AddisonsUK @StNurseProject
11%10%
33%30%
33%60%
22%90%
18 votes • Final results 1
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🥉Not Quite:
The adrenal cortex like many organs in the body has a lot of redundancy built into it. Clinical signs & symptoms don’t usually present until 90% of the function has been impaired.
#TweetAnatomy on #InternationalAddisonsDay #Endocrine
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@AddisonsUK can be #life threatening if it is not recognised & treated quickly
Good news: lifesaving treatment is quick & effective💉
#TweetAnatomy on #InternationalAddisonsDay MCQs about this condition 4 @WeParamedics @WeNurses
@RCNStudents #StNProject answers later!
@cpdme
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Q1: Primary adrenocortical insufficiency is associated with a deficiency of which one of the following hormones?
#TweetAnatomy on #InternationalAddisonsDay #Endocrine @WeStudentNurse
51%Cortisol
11%Aldosterone
5%Androgens
32%All of the above
74 votes • Final results🥈Sorry Not Quite:
Adrenocortical insufficiency causes a lack of all hormones that are secreted by the adrenal cortex.
While cortisol is the best recognised in #Addisons disease there is also deficiency of androgens & aldosterone.
#TweetAnatomy on #InternationalAddisonsDay
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This might give you a clue as to what the questions are on today on #TweetAnatomy for #InternationalAddisonsDay @AddisonsUK
Let's reach out to raise awareness of this important #endocrine condition today @SalfordNurSoc @HullNursing
Q3: Immune complexs can cause injury to which one of the following organs?
#TweetAnatomy #ACP #MedEd
15%Liver
31%Kidney
54%Spleen
0%Heart
13 votes • Final resultsQ2: Heparin induced thrombocytopenia is associated with which one of the following classes of hypersensitivity?
#ACP #PhysicianAssociate #MedEd #FOAMed
#TweetAnatomy
8%Class 1
75%Class 2
8%Class 3
8%Class 4
12 votes • Final results 1
Today on #TweetAnatomy we are going to be talking about #Hypersensitivity #reactions. Keeping with our #immunology theme.
Hope that some from @WeStNurse @SalfordSoc will be able to take part along with #Paramedic #ACP and # PhysicianAssociate Colleagues. #MedEd #FOAMed
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Here is an easy one to get us started,
Q1: Immunoglobulin E acts as a receptor on which one of the following cell types?
#TweetAnatomy #StudentNurse #StNP
60%Mast Cells
20%Basophils
20%CD20 Cells
0%Macrophages
5 votes • Final results