Addison’s disease Flashcards
1ry adrenal insufficiency (Addison’s disease)
Reduction in secretion of cortisol & aldosterone
Cause of 1ry adrenal insufficiency
Damaged adrenal glands
Most common cause of 1ry adrenal insufficiency
Autoimmune
Aetiology of 2ry adrenal insufficiency
Inadequate ACTH —> low cortisol
Cause of 2ry adrenal insufficiency
Loss/damage to pituitary glands
Aetiology of 3ry adrenal insufficiency
Inadequate CRH release by hypothalamus
Cause of 3ry adrenal insufficiency
Long-term steroids —> hypothalamus suppressed
How to prevent adrenal insufficiency when prescribing cortisol
Slow withdrawal of oral steroids —> allow hypothalamus to adapt
General symptoms of adrenal insufficiency
- fatigue
- nausea
- cramps
- abdominal pain
- reduced libido
Explain the bronze hyperpigmentation in adrenal insufficiency
ACTH stimulates melanocytes —> + melanin
Explain hypotension in adrenal insufficiency
Low Na+
Levels of Na & K in adrenal insufficiency
- hyponatraemia
- hypokalaemia
In a short synacthen test what would conclude a 1ry adrenal insufficiency
failure of cortisol to rise (at least double baseline)
ACTH levels in 1ry adrenal insufficiency
High
ACTH levels in 2ry adrenal insufficiency
Low
