Addison's and Conn's Flashcards
Define addison’s.
primary adrenal insufficiency - decrease in the production of adolsterone + cortisol
What are the symptoms of addison’s disease?
hypocortisolaemia -lethargy, weakness, anorexia -N&V -hypoglycaemia Sx hyperaldosteronism -Hypotension Sx - dizziness and syncope -hyponatraemia + hyperkalaemia hypoandrogenism -decreased libido -loss of pubic hair increased ATCH -hyperpigmentation of the hands
CRISIS - collapse, shock, pyrexia
What is the most common cause of addison’s? What is the most important causes clinically?
- common = autoimmune destruction of the adrenals
- important = sudden discontinuation of corticosteroids
What’s the test of addison’s?
ACTH stimulation test i.e. short synacthen test
- measure cortisol before and 30 mins after giving synacthen IM
- won’t increase in primary, will in secondary and may a little in tertiary
can also do morning serum cortisol and ATCH before
How do you treat addison’s?
- fludrocortisone + hydrocortisone - split in 2-3 doses throughout the day
- hydrocortisone + needles to treat crisis
- educate on the importance of not missing doses
- intercurrent illness education (double hydro dose)
- medical alert bracelet
What is Conn’s syndrome more accurately known as?
-primary hyperadolsteronism
What are the common causes of primary hyperaldosteronism?
- idiopathic bilateral adrenal hyperplasia (60%)
- adrenal adenoma - adolderstonoma
What are the 2 catergories of symptoms causes by hyperaldosteronism?
- hypertension - aldosterone stimulates increase of H20 + Na reabsorption in the kidney
- Hypokalaemia - happens as a result of Na + retention
How can you test for conn’s?
going to be done in the clinical picture of refractory HTN w/ concurrent hypokalaemia
- plasma aldosterone concentration (PAC)
- CT adrenals
Treatment for Conn’s?
- spironolactone
- adrenalectomy
