Addison's disease

Question 1

Addison’s disease ( primary adrenal insufficiency)

Answer 1

Localised problem of the adrenal gland as a result of progressive damage which results in insufficient hormone production

Question 2

Aldosterone function

Answer 2

1. Decrease potasisu
2. Increase sodium
3. Increase blood volume and pressue

Question 3

Causes of primary adrenal insufficiency

Answer 3

1. Developed countries = autoimmune destruction
2. Developing countries = tuberculosis ( spreads from lungs to adrenal glands causing inflammation)
3. Metastatic carcinoma - spreads to the adrenal cortex from else where

Question 4

Pathophys if Zona glomerulosa destroyed

Answer 4

•Once symptoms start to show 90% of the adrenal cortex has been destroyed
1. Zona glomerulosa has been destroyed aldosterone levels fall
• leaving high potassium levels in the blood
• Low sodium levels in the blood
• Metabolic acidosis ( buid up of H+ in blood)

Question 5

Symptoms if zona glomerulosa is destroyed

Answer 5

• Cravings for salty foods
• Nausea and vomiting
• Dizzyness

Question 6

Pathophys if zona fasciculata is destroyed

Answer 6

1. Cortisol levels fall
2. Low blood glucose level in time of stress
3. Cortisol usually inhibits pituitary gland thus will cause
   • pituitary gland to become overactive
   • Pituitary gland produce proopiomelanocortin
   • Precursor to adrenocorticotropic hormone and melanocyte stimulating hormone -> hyperpigmentation of skin

Question 7

Pathophys zone reticularis affect

Answer 7

1. Androgen levels fall
2. Loss of pubic and armpit hair
3. Decreased sex drive

Question 8

Addisonian crisis

( acute primary adrenal insufficiency)

Answer 8

1. Symptoms are slow and progressive
2. Symptoms will be ignosed
3. Major stressor occurs - sudden need for cortisol/aldosterone

Question 9

Addisonian crisis symtoms

Answer 9

1. Pain in back, abdomen and legs
2. Vomitting and diarrhea -> dehydration
3. Low blood pressure - loss of consciousness
4. Death

Question 10

Waterhouse-friderichsen syndrome

Answer 10

CAUSE OF ACUTE PRIMARY ADRENAL INSUFFICIENCY
• Sudden increase in blood pressure
• Blood vessels in adrenal cortex rupture
• Adrenal gland swells up with blood causing tissue ischaemia
• Adrenal gland failure

Question 11

Diagnosis

Answer 11

Adrenocorticotropic hormone stimulation test

1. Give synthetic ACTH
2. Measure cortisol and aldosterone produced
3. Tells you how well glands are working

Question 12

Treatment

Answer 12

1. Hormone replacement lifelong