Addison's disease Flashcards

1
Q

What is the definition of addisons disease?

A

Primary adrenal insufficiency

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2
Q

How common is addisons disease?

A

Rare. Incidence about 1 in 10,000 people

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3
Q

What is the pathophysiology of addison’s disease?

A
  • Adrenal gland does not produce enough glucocorticoid and mineralocorticoid (aldosterone) due to destruction of adrenal cortex
  • Autoimmune – antibodies against steroid 21-hydroxylase can be found in 85% of patients
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4
Q

What is the aetiology/risk factors for addison’s disease?

A
  • Autoimmune diseases
  • Corticosteroid withdrawal – causes atrophy of the adrenal gland
  • Genetic
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5
Q

What are the signs/symptoms of addison’s disease?

A
  • ‘Lean, tanned, tired and tearful’
  • Weakness
  • Anorexia
  • Dizzy/faint
  • Myalgia/arthralgia
  • Depression/psychosis/low self esteem
  • Nausea/vomiting
  • Abdominal pain
  • Diarrhoea/constipation
  • Pigmented palmar creases and buccal mucosa
  • Postural hypotension
  • Vitiligo – pale patches on skin
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6
Q

What investigations are carried out for suspected addison’s disease?

A
  • ↑ K+, ↓ Na+
  • ↓ glucose
  • ↑ urea
  • ↑ Ca2+
  • ↑ Eosinophils
  • ↓ FBC (anaemia)
  • ACTH stimulation test/Synacthen test: test plasma cortisol before and 30 mins after tetracosactide. Test is +ve is 30 min cortisol <550nmol/L
  • Plasma renin and aldosterone
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7
Q

What are the pharmacological treatments for addison’s disease?

A
  • Hydrocortisone daily

* Fludrocortisone

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