Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > Addisons disease > Flashcards

Addisons disease Flashcards

1
Q

What causes addisons disease

A

Lack of aldosterone and coritisol
primary hypoadrenalism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why does addisons cause bronzed skin and where is the first place its seen

A

Melanin production from ACTH excess
First place seen is the gums

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What treat addisonian crisis with

A

Hydrocortisone IV + fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is an acute adrenal crisis

A

hypovolaemic shock as no pressure from adrenergic receptors
Hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What electrolyte imbalance is seen in addisons

A

Acidosis - hyperkalmaeia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What need to check before giving levothyroxine

A

Cortisol levels - levothyrozine increases cortisol metabolism - can send into addisonian crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cortisol function

A
  • Blood sugar regulation
  • BP control
  • Antinflammatory effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is addisons disease

A

Primary adrenal insuffiency -> lack of aldosterone and cortisol due to destruction of adrenal cortex
Excess ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of addisons

A

Autoimmune
TB - most common globallu
Adrenal metastasis
Bilateral adrenalectomy
Adrenal haemorrhage
Infections
Genetic conditions
pROLONGED use of glucocorticids or drugs inhibiting steroid production eg ketoconazole supress HPA axis -> adrenal atrophy and insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Infections that can cause addisons

A

histoplasmosis, crytpococcosis, CMV, HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Genetic conditions causing addisons

A

Amyloidosis and haemochromatosis
Congenital adrenal hyperplasia
Congenital or neonatal primary adrenal insuffficiency - CYP21A2, AIRE 9APS-1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is there excess of ACTH in addisons disease

A

Lack of aldosterone and cortisol stimualtes release but cortex cant respond to ACTH due to destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prognosis of addisons

A

20-30 yr old women more common
If untreated always fatal
Require lifelong treatment, premature risk of death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical features of addisons

A

Weight loss
Anorexia
Slat cravings
Malaise + easy fatiguabilit
Weakness
Fever
Depression
Impotence/amenorrhea
N+V
Diarrhoea Confusion
Syncope
Abdo pin
Constipation
Myalgia
Joint or back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Signs of addisons disease

A

New scars, palmar crease pigementation
Buccal pigmentation
Postural hypotension
Weight loss
General
Dehydration
Loss of body hair
Vitilifo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

WHat causes pigmentation in addisos

A

POMC -> increased Melanocyte StimHoromne - dark skin

17
Q

Electrolytes in addisons

A

Hyponatermia
Hyperkalemia
Metabolic acidosis

18
Q

How do a short synacthen test

A

Cortisol at 0 minutes - gie ACTH 250mg
Cortisol level at 30+60 mins

19
Q

What result from short synacthen test diangoses addisons

A

<500 at 30 or 60 mins

20
Q

When should short synacthen test be perfrmed

A

18-24 hours after last steroid dose

21
Q

Management of addisons

A

Gluco and mineralcorticoid replacement
Glucocorticoid replacement - hydrocortisone, prednisolone, dexamethasone
Mineralcorticoid replacement - fludrocortisone

22
Q

When do yuo double glucocortiocids taken in addisons

A

unwell - moderate fever, infection with antibiotics, local anaesthetis

23
Q

What causes an addisonian crisis

A

Lack of steroids - first presentation of addisons or not enough steroids given, taken, retained etc

24
Q

Clinical features of addisons

A

Fatigue, weight loss, no energy
Hypotnesion 0 dizzym collapse, shok
Abdo pain - tender, guarding, N+V
Fever
Confusion - somnolence, delirium, coma
Back and leg cramps

25
Q

Biochem results in addiosnian crisis

A

Hyponatermia
hyperkaelmia
Hypoglycaemia
Pre renal failure

26
Q

Investigations in addisons cirsis

A

Cortiosl, U+Es, TFTs, ACTH, FBC
BP
Drug hisory #Dont wait to treat if sus

27
Q

Treatment of addisonian crisis

A

IV bolus of 100mg IV hydrocortisone
Cont 200mg IV hydro per 24 hours, or 50mg every 6
Rehydration - rapid 1000ml first hour

28
Q

When give hydrocortisone IV 100mg in addisons

A

Severe illness eg persistent vomitting, prep for colonosopy, acute trauma or surgery any major stressors

29
Q

What give in adrenal crisis initially

A

IM hydrocortisone - 100mg emergency it

30
Q

Why is it important to treat an addisonian crisis so quickly

A

Hypovolaemia -> ischamia and end organ damage
Death

31
Q

What 9amcortiisol level would make addisons more or less liely

A

> 500 - v unlikely
<100 = v abnormal
100-500 - > ACTH stim tst

32
Q

What antibpdies can be seen in addisons

A

anti-21-hydroxylase

33
Q

What need to monitor in addisons

A

Osteoporosis due to long term steroid use - DEXA scans and give vit D

34
Q

Addisons definitive investiation

A

ACTH stimulation test - short synacthen test

35
Q

How is ACTH test done

A

PLasma cortisol measred before and 30 mins after 250ug IM stnacthen

36
Q

Management addisons crisis

A

hydrocortisone 100 mg im or iv
1 litre normal saline infused over 30-60 mins or with dextrose if hypoglycaemic
continue hydrocortisone 6 hourly until the patient is stable.
oral replacement may begin after 24 hours and be reduced to maintenance over 3-4 days

Endocrine (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions