Adrenal Gland Problems Flashcards
What are the hormone levels in adrenal insufficiency?
Low cortisol and aldosterone
What is the main cause of adrenal insufficiency?
Autoimmune - Addison’s (primary)
What are the main signs and symptoms Addison’s disease?
- Abdominal pain
- N&V
- Hyponatraemia
- Hyperkalaemia
- Hypotension
- Fatigue and weakness
- GI symptoms
- Syncope
- Pigmentation (due to an increase in ACTH pre-cursors).
How do you diagnose Addison’s disease?
- Morning serum cortisol (first line)
- ACTH (short Synacthen) stimulation test (to confirm diagnosis)
How do you treat Addison’s disease?
- Fluids
- Hydrocortisone and fludrocortisone (acute in crisis = IV fluids and IV hydrocortisone)
What are the hormone levels in Cushing’s syndrome?
High cortisol
What is the main cause of Cushing’s syndrome?
Steroids (+ Cushing’s disease)
What are the main signs and symptoms Cushing’s syndrome?
- Moon face
- Central obesity
- Striae
- Hyperglycaemia
How do you diagnose Cushing’s syndrome?
Overnight dexamethasone suppression test
How do you treat Cushing’s syndrome?
Stop steroids (or surgery if tumour)
What are the hormone levels in phaeochromocytoma?
High adrenaline + noradrenaline (catecholamines)
What is the main cause of phaeochromocytoma?
Catecholamine producing tumour in the adrenal medulla (phaeochromocytoma)
What are the main signs and symptoms of phaeochromocytoma?
- Headache
- High HR (palpitations)
- Sense of doom
- Malignant hypertension
- Sweating
How do you diagnose phaeochromocytoma?
- Plasma (or urine 24h) meta-adrenalines/metanephrines
- CT > MRI
How do you treat phaeochromocytoma?
Surgery (abdominal) + pre-op alpha/beta blockade
