Adrenal Insufficiency Flashcards
What is Addison Disease?
Autoimmune destruction of the adrenal cortex, leading to decreased aldosterone and cortisol.
Why is Addison Disease called ‘primary adrenal insufficiency’?
Because the adrenal gland itself is under-producing hormones.
What hormones are predominantly affected in Addison Disease?
Aldosterone and cortisol.
What are common electrolyte imbalances seen in Addison Disease?
Decreased Na+, increased K+, decreased pH, decreased bicarbonate.
What is the typical blood pressure presentation in patients with Addison Disease?
Low-normal or low blood pressure due to decreased aldosterone and cortisol.
What causes hyperpigmentation in Addison Disease?
Increased ACTH and a-MSH due to decreased cortisol.
What is a notable blood finding in patients with Addison Disease?
Eosinophilia.
Why do patients with Addison Disease present with eosinophilia?
Due to decreased cortisol, which normally helps sequester eosinophils and facilitates their apoptosis.
Fill in the blank: Addison Disease can be seen in patients with a history of other ______ diseases.
autoimmune
What is the classic vignette presentation of Addison disease?
Ongoing fatigue + hyperpigmentation
This presentation can occur in both young and old patients.
What is the key diagnostic test for Addison disease?
ACTH stimulation test (also called cosyntropin stimulation testing)
What should normally happen after administering exogenous ACTH?
A robust increase in cortisol from the adrenal fasciculata
What happens in primary adrenal insufficiency when exogenous ACTH is administered?
Cortisol levels do not increase
What is a significant consequence of low cortisol levels?
Chronic fatigue syndrome
What should be checked in patients with unexplained chronic fatigue?
Cortisol levels
What is the immediate treatment for low cortisol levels?
Hydrocortisone
What is the primary treatment for Addison disease?
Fludrocortisone +/- hydrocortisone
Fludrocortisone is often used in combination with hydrocortisone for optimal management of Addison disease.
What type of hormone is fludrocortisone?
Mineralocorticoid
Fludrocortisone mimics the action of aldosterone.
Fludrocortisone is similar to which hormone?
Aldosterone
Aldosterone is a hormone that helps regulate sodium and water balance in the body.
What type of hormone is hydrocortisone?
Glucocorticoid
Hydrocortisone is structurally similar to cortisol, which is involved in stress response and metabolism.
Hydrocortisone is similar to which hormone?
Cortisol
Cortisol plays a crucial role in the body’s response to stress and regulation of metabolism.
Potential symptoms of adrenal insufficiency include
Salt craving (mineralocorticoid) deficiency), depressed mood/fatigue (glucocorticoid), reduced secondary sexual characteristics in women (androgens)
