Adrenal insufficiency

Question 1

Glucocorticoid defi

Answer 1

Fatigue weakness , annorexia, hypoyension hypoglycemia

Question 2

Mineralocorticoid

Answer 2

Salt craving -

Question 3

Primary insuff

Answer 3

ACTH will be elevated, Cortisol - decreased

Question 4

Mineralocoritcoid secretion

Answer 4

Intact in central deficiency because it is more dependent on renin agniotensin

Question 5

Addisons disease

Answer 5

Hyperpigmentation of gingiva and hand creases

Question 6

Why do you get hyperpigmentation

Answer 6

ACTH - cross reactivitty with MSH receptro

Question 7

APECED

Answer 7

Autoimmune polyendocrinopathy Cabdidiasis, Ectodermal Dystrophy

Question 8

Adrenal crisis - management

Answer 8

Fluid resus
Correction of hypoglycemia
Steroids - (50-75 mg/M squared) - infant - 25, 50 , 100 mg for infant child and teenager
Sent corticol and ACTH

Subsequent stress dosing 50-75 mg/m2 /d
You will need to give fludorcortisone

Question 9

ACTH/ Cortisol - which trumps

Answer 9

ACTH - if high it does not matter about cortisool level

Question 10

Adrenal Leukodystrophy

Answer 10

x linked -
4- 10 years
very long chain FA build up in brain

manifestations - demyelination -
Behavioural changes, inattention
Visual symptoms, audtory processing

Progression is rapid
Can present with adrenal insufficiency

Question 11

Drugs that inhibit steroid biosynth

Answer 11

etomindate and pressidex