Addison's Flashcards
What is Addison’s?
Primary adrenal insufficiency
Who is Addison’s more common in?
Women
Ages 30-50
What are the risk factors for Addison’s?
Cancer, anticoagulants, chronic infections (TB), surgery to remove part of adrenal gland, autoimmune disease
How does Addison’s present?
Fatigue, weakness, anorexia, weight loss, nausea, abdominal pain, darkened skin, depression, syncope, myalgia, diarrhoea, constipation
What are the causes of Addison’s?
Autoimmunity, infection (TB), infiltration, malignancy, genetic, vascular, iatrogenic (adrenalectomy, drugs), HIV, lymphoma, sarcoidosis
What is the pathophysiology of Addison’s?
Primary adrenal insufficiency as a result of destruction of the adrenal gland or genetic defects in steroid synthesis
Low levels of cortisol and aldosterone
What are the investigations for Addison’s?
U+Es - hyponatraemia, hyperkalaemia, raised urea
Hypoglycaemia
FBC - mild anaemia
Low 9am cortisol, raised ACTH concentration, SST cortisol levels will not change (normal would increase)
What is the management for Addison’s?
Lifelong glucocorticoid and mineralocorticoid replacement therapy - hydrocortisone and fludrocortisone
What are the complications of Addison’s?
Addisonian crisis - low levels of cortisol causing dizziness, weakness, sweating, LOC
How is an Addisonian crisis treated?
IV or IM hydrocortisone given immediately
IV fluids
Which part of the adrenal gland produces aldosterone?
Zona glomerulosa
Which part of the adrenal gland produces cortisol?
Zona fasciculata
Which part of the adrenal gland produces oestrogen and testosterone?
Zona reticularis
What does the medulla of the adrenal gland produce?
Adrenaline, noradrenaline, somatostatin
