Adrenal glands

Question 1

Addison’s disease

Answer 1

• umbrella term of primary adrenal insufficiency,
• a nuber of diseases which all have decreased secretion of cortiol (stress hormon) and aldesterone
  by adrnal glands.

Question 2

Addisson’s disease causes and characteristics

Answer 2

• there are numerous cuses of Addison’s disease:
• pre -existing diseases, autoimmune-related diseases,such as Graves disease, type 1 diabets, premautre ovarian failure, coliac disease
• adrenal cortex is progressively destroyed by the body’s ownd immune system.
• disease is slow to develop, often misdiagnosed with depression or anorexia until thye present in crisis

Question 3

Adrenal crisis

Answer 3

-addison’s disease going into crisis
-most common cause is vomiting and/or diarrhoea
- pt require hydrocortisone injection

Question 4

Adrenal crisis signs and symptoms

Answer 4

• cachexia and overpigmentation of the skin, pt may look tanned, have pigmentiation of the palmar crses, muddy brown patches in the mucous membranes of the lips nad mouth.
• Addisons mnemoinic:
  A always tired
  D dizzy when standing
  D drop in blood pressure on stanidng
  I inexplicable weight loss
  S skin coulour changes
  O only eating sparingly/ anorexia
  N no strength in hadgrip or limbs
  S sick or nauseous

Question 5

Adrenal crisis sign and symptoms

Answer 5

• severe hypotension or shock ,
• acute abdominal pain
• vomiting and pyrexia
• in children, hypoglyaemic convlusions are a common presentation
• clues: Addison’s disease Medic Alert bracelet and glucocorticoi an mineralocorticoid replacemnet medicatin

Question 6

Adrenal crisis management

Answer 6

• if they not vomiting then : oral dose of theirs hydrocortisone
• IM or IV hydrocortisone asap (its better to administer it if their is doubt, than to withold it)
• pt may be hypotesive and hypoglycaemic (treat it with IV fluids and glucose )
• oral glucose and IM glucagon can be administered
• frequently recheck blood glucose
• pre-alert hospital