Adrenal Insufficiency Flashcards
What hormones will be depleted in Addison’s/
Cortisol, Aldosterone and sex hormones
What hormone levels will be high in primary Addison’s?
CRH and ACTH
Why is there hyperpigmentation in Addison’s Disease?
Excess production of ACTH and CRH being deposited in the SK
What three unexplained features does Addison’s present with?
Fatigue, hyponatraemia and hypotension.
hyperpigmentatiion is present in 90% of cases
What are the actions of Aldosterone?
Retention of Na
Excretion of K and Ca
What are the main actions of Cortisol?
Anti-inflammatory
Gluconeogenisis
Protein Metabolism
Fat Metabolism
How would you investigate a patient for Addison’s Disease?
Bloods - high K and Ca but hyponatraemic
Glucose
Random serum Cortisol
ACTH stimulation test
How is a ACTH stimulation test carried out and what would it show in a patient with Addison’s?
Patient is given a dose of synthACTHin which raises cortisol.
Blood taken at 0 and 30 mins. Cortisol should rise. If does not reach 550mmol then Addisons
How should you deal with a patient who is suspected hypoadrenal and is hypotensive?
Give hydrocrotisone and saline immediately, before the diagnosis is made.
What are the two main causes of secondary hypoadrenalism?
Long term steroid therapy causing hypothalamus pituitary suppression
a primary depletion of ACTH
How would you test to distinguish primary from secondary hypoadrenalism?
Test blood levels of ACTH
