Adrenal Disorders

Question 1

What disease is caused by primary adrenal failure?

Answer 1

Addison’s

Question 2

What disease is caused by excess cortisol production?

Answer 2

Cushing’s

Question 3

Describe how Addison’s disease is usually caused in UK and in LEDCs

Answer 3

Autoimmune destruction of adrenal cortex (most common UK)

TB in adrenal glands. (most common globally)

Question 4

What does the onset of Addison’s lead to increased production of?

Answer 4

Lots of ACTH and MSH (Melanocyte stim)

Question 5

What are the symptoms of Addison’s?

Answer 5

Weakness as Na decreases
Hypotensive due to lack of Na
Atrophy of adrenal gland
Increased inappropriate pigmentation (e.g. mouth)
Low Na+, High K+

Question 6

How is an Addisonian crisis treated?

Answer 6

Rehydrate w/saline

Dextrose to prevent hypoglycaemia from glucocorticoid deficiency

Give Hydrocortisone/another glucocorticoid

Question 7

What are the symptoms of Cushing’s disease (excess cortisol production?)

Answer 7

Impaired glucose tolerance (T2DM) due to increased blood glucose concentration

Weight gain (more fat, less protein)

Thin skin, with easy bruising

Striae (Stretch marks)

Proximal Myopathy (weakness of large muscles)

Mental changes (depression)

Hypertension

Fat redistribution

Moon face

Interscapular fat pad

Hirsutism and acne (zona reticularis)

Question 8

What are the four most common causes of Cushing’s syndrome?

Answer 8

Oral Steroids
Pituitary adenoma producing excess ACTH
Ectopic ACTH (e.g. by lung cancer cells)
Adrenal adenoma/carcinoma

Question 9

What is Conn’s syndrome?

Answer 9

Aldosterone producing Adenoma;
Tumour of zona glomerulosa
Na retention, K loss
Hypotension, oedema, hypokalaemia