Addison's

Question 1

What is Addison’s?

Answer 1

Primary adrenaline insufficiency

Question 2

What does Addison’s cause?

Answer 2

Deficiency of both aldosterone and cotrisol

Question 3

What is the role of aldosterone?

Answer 3

Regulation of BP, Na and K

Question 4

What is the role of cortisol?

Answer 4

Increase blood sugar
Anti-inflammatory
Metabolism of fat, protein and carbs

Question 5

What are the causes of addison’s?

Answer 5

Most common= autoimmune
Infection
Maliganncy
Infarction
Drugs

Question 6

What is the pathology in autoimmune Addison’s?

Answer 6

Autoantibodies against 21 hydroxylase and/or adrenal cortex

Question 7

What are the clinical features of Addison’s?

Answer 7

Anorexia and weight loss
Hyperpigmentation
Weakness and fatigue
Hypotension, syncope
Unexplained D&V
Salt craving

Question 8

What investigations are done for Addison’s?

Answer 8

FBC, U&Es, glucose, autoantibodies
Random cortisol
Synacthen and basal ACTH

Question 9

What do the bloods in Addison’s show?

Answer 9

Low Na, high K
Low blood sugar
Random cortisol <700

Question 10

What is the management of an adrenal crisis?

Answer 10

Acutely unwell, treat then investigate
IV hydrocortisone
IV saline
IV dextrose

Question 11

What is the chronic management of Addison’s?

Answer 11

Glucocorticoid and mineralocorticoid replacement= hydrocortisone/cortisone/pred and fludrocortisone
Give in divided doses and never miss

Question 12

What are the rules in Addison’s management?

Answer 12

Never miss a dose
Double hydrocortisone if intercurrent illness
Severe D&V, call for help ASAP

Question 13

What is the presentation of an adrenal crisis?

Answer 13

Severe D&V
Dehydration, hypotension, syncope
Confusion, slurred speech, convulsions
Hypoglycaemia, hyponatraemia, hyerkalaemia