Adrenal insufficiency

Question 1

What is addisons disease?

Answer 1

Is an autoimmune disease where adrenal glands have been damaged

Question 2

what is secondary adrenal insufficency?

Answer 2

Low amount of ACTH is stimulating the adrenal gland which results in low cortisol release. This happens due to surgical removal of pituitary tumour , infection, loss of blood flow.

Question 3

Causes for addisons diseasse?

Answer 3

In developed countries most common cause is autoimmune destruction.

In devloping countries main cause is tuberculosis where it spreads to adrenal cortex

Metaplastic carcinoma where cancer spreads from somewhere in body to adrenal cortex

Question 4

How to diagnose adrenal insufficiency?

Answer 4

Short synACTH test

this is where synthetic ACTH is given and the cortisol and aldosterone levels are measured.

Question 5

symptoms of adrenal insufficiency?

Answer 5

Symptoms depend on the layer damaged:

Zona glomerulosa:
Hyperkalemia = High potassium
Hyponatremia = Low sodium
Hypovalemia = Low water in blood
Acidosis = increase hydrogen ions

zona fasiculata:
Cortisol levels low = tiredness, weak

Zona reticulars:
Androgen levels drop
men will not be affected as testes will produce more androgen
woman will have low sex drive, loss of pubic and arm pit hair
Main signs are hyperpigmentation and hypotension

Question 6

Treatment for adrenal insufficency?

Answer 6

Replacment steroids to be taken:

Cortisol = Hydrocortisone
Aldosterone = Fludrocortisone