Addisons Flashcards
How could you tell between Addisons caused by pituitary disorder or by adrenal disorder?
Adrenal disorder would affect both mineralo and glucocorticoid, whereas pituitary disfunction would only affect glucocorticoid as mineralocorticoid release isn’t controlled by ACTH
How would an addisonian crisis present?
Nausea, vomiting, hypotension, dehydration, confusion leading to coma & death.
How would you treat an addisonian crisis?
IV fluids & IV cortisol & dextrose
Possible triggers of an addisonian crisis?
Stress, excessive prolonged use of glucocorticoids, infection, surgery of adrenal gland
What can cause Addison’s disease?
Autoimmune destruction of adrenal cortex OR disorder or anterior pit/hypothalamus leading to less secretion of ACTH or CRF
If you wanted to test plasma cortisol level to rule out Addisons, what time would you take a reading?
Morning- around 6am when cortisol should be at its highest
What test, other than plasma cortisol would be used to diagnose Addison?
SynACTHen test- synthetic analogue of ACTH applied intramuscularly. Normally- would raise cortisol by >200, if it doesn’t: Addisons Disease
Why may somebody with Addisons present with hyperpigmentation?
As no/little cortisol produced, little negative feedback on ACTH levels. These rise, as alpha MSH sequence is present in ACTH sequence, melanocytes and stimulated to release melanin causing pigmentation.
What is Addisons most often due to? How could you tell?
Autoimmune destruction of all 3 adrenal cortex layers, if so you’d have low levels of all hormones.
What is another, not so common cause of Addisons?
Low levels of CRF or ACTH due to hypothalamic/pituitary disorder
Why would you administer dextrose for addisonian crisis?
As cortisol acts to increase plasma glucose levels by increasing gluconeogenesis etc, they would be severely hypoglycaemic
If Addisons was left untreated, how may the blood results for Na, K and sugar present?
Hyponatraemia, hyperkalaemia, hypoglycaemia
