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
Adrenal autoantibodies found in adrenal insufficiency
- adrenal cortex antibodies
- 21-hydroxylase antibodies
function of hydrocortisone in adrenal insufficiency tx
Replace cortisol
Function of fludocortison in adrenal insufficiency tx
Replace aldosterone
Addisonian crisis definition
Acute presentation of severe Addison’s
Symptoms of Addisonian Crisis
- reduced consciousness
- hypotension
- hypoglycaemia
- hyponatraemia/hyperkalaemia
5 steps of correcting Addisonian crisis (misic)
- monitor electrolytes + fluid balance
- intensive monitoring
- (parenteral) steroids
- IV fluid resuscitation
- correct hypoglycaemia
