adrenal insuff.

Question 1

2 main types

Answer 1

1. primary - addisons

2. secondary

Question 2

4 cause of addisons

Answer 2

1. idiopathic likely autoimmune
2. infections - TB
3. iatrogenic - bilat adrenalectomy
4. mets

Question 3

most common cuase of secondary

Answer 3

steroids - MOST COMMON CAUSE

Question 4

2 main issues with AI

Answer 4

1. lack of cort.

2. lack of aldo

Question 5

low cort Sx

Answer 5

1. GI - anorexia, N/V abdo pain
2. mental lethargy, confusion
3. hypoglycemia
4. HTN esp ortho
5. hyperpigmentation

Question 6

low aldo Sx

Answer 6

1. Na loss causing hyponatremia and hypovolemia

2. hyperkalemia

Question 7

4 Dx of AI

Answer 7

1. low plasma cortisol
2. plasma ACTH levels - if low implies secondary
3. standard ACTH test
   - give IV ACTH and measure cort at end
4. imaging - depending on where

Question 8

Tx of primary and secondary

Answer 8

1. daily PO prednisone and fludrocortisone

2. same as for primary, but don’t ned mineralocort