Addison's Disease Flashcards
What is Addison’s disease?
Autoimmune destruction of the adrenal glands
What is Addison’s a primary form of?
Primary adrenal insufficiency
What is there a reduced production of in Addison’s?
Cortisol
Aldosterone
What is the most common cause of Addison’s worldwide?
Tuberculosis
How does Addison’s present?
Trim Tanned Tired Tearful Pigmented palmar creases
What is an alternative way that Addison’s can present?
Nausea
Vomiting
Weakness
Weight loss
Why does someone with Addison’s crave salt?
Due to hyponatraemia
What is the first line investigation for Addison’s
?
Short Synacthen test
What is the short synactehn test?
ACTH stimulation test
What does a Short synacthen test involve?
Measure plasma cortisol before giving it
Measure cortisol 30 minutes after giving it
What investigation would you do if ACTH not available?
9am serum cortisol
What antibody can you test for in Addison’s?
21-hydroxylase antibody
What electrolyte imbalances would you expect in Addison’s?
Hyponatraemia
Hyperkalaemia
Hypercalcaemia
Hypoglycaemia
Metabolic acidosis
What is sometimes the only sign of Addison’s?
Hyponatraemia
What is the management of Addison’s?
Hydrocortisone
Fludrocortisone
What is hydrocortisone?
A glucocorticoid
How should the hydrocortisone be administered?
Majority of it should be given in the first part of the day
What is fludrocortisone?
Mineralocorticoid
What is the function of fludrocortisone?
Hypotension
Hyponatraemia
Hyperkalaemia
If the patient is ill, how should the treatment be changed?
Double the hydrocortisone
Keep the fludrocortisone the same
What is an Addisonian crisis?
The absence of steroid hormone leads to life-threatening disease
How does an Addisonian crisis present?
Reduced consciousness- shock, collapse and pyrexia
Hyponatraemia, Hyperkalaemia, Hypercalcaemia
What is the management of an Addisonian crisis?
IV/IM hydrocortisone
100mg every 6 hours
What is secondary adrenal insufficiency?
Inadequate ACTH stimulating the adrenal gland
What is secondary adrenal insufficiency due to?
Damage to the pituitary gland
What is the main cause of secondary adrenal insufficiency?
Sheehan’s syndrome
What is tertiary adrenal insufficiency?
Inadequate CRH from the hypothalamus
What is tertiary adrenal insufficiency due to?
A patient taking long term steroids
What is the most common cause in the UK of hypoadrenalism?
Autoimmune destruction of the adrenal gland
What can occur in women with addisons?
Loss of pubic hair
