Adrenal Steroids - Adrenal Pathology Flashcards
What is another name for Primary Chronic Adrenocortical Insufficiency?
Addison’s Disease. Called primary because it affects the end organ (adrenal gland)
What causes Addison’s Disease?
Atrophy (auto immune?) or destruction of the adrenal cortex by metastatic carcinoma or infection.
What is deficient in Addison’s Disease?
Cortisol and aldosterone production
What are some symptoms of Addison’s Disease?
Weakness, Weight loss, anorexia, GI disturbance
Hyperpigmentation
Hypoglycemia, hyponatremia, hyperkalemia
What causes hyper pigmentation in Addison’s Disease?
Loss of negative feedback means more ACTH release activates the melanocyte 1 receptor which leads to hyperpigmentation
What causes hyponatremia in Addison’s Disease?
You don’t have enough Aldosterone bringing sodium back at the expense of potassium, so hyponatremia and hyperkalemia
What causes hypoglycemia in Addison’s Disease?
Glucocorticoids cause gluconeogenesis, so you have less cortisol in the blood with Addison’s = less glucose
What causes Secondary Chronic Adrenocortical Insufficiency?
Deficient cortisol production due to decreased ACTH secretion
Do you get hyper pigmentation in Secondary Chronic Adrenocortical Insufficiency?
No because you are not releasing ACTH
How do you diagnose Secondary Chronic Adrenocortical Insufficiency?
Infuse ACTH and see if it causes stimulation of cortisol production
What is the treatment for both Primary (Addison’s) and Secondary Adrenocortical Insufficiency?
Cortisol replacement therapy
Which has milder symptoms, Primary (Addison’s) or Secondary Adrenocortical Insufficiency?
Secondary. Milder symptoms than Addison’s - less electrolyte imbalance and no hyperpigmentation
What causes Acute Adrenocortical Insufficiency?
Rapid onset of adrenal insufficiency - often caused by an abrupt withdrawal of high doses of exogenous corticosteroids.
What are the symptoms of Acute Adrenocortical Insufficiency?
Weakness, GI disturbances, dehydration, hypotension
What is the treatment of Acute Adrenocortical Insufficiency?
STAT replacement of salt, glucose and water along with IV cortisol