Adrenal Steroids - Adrenal Pathology Flashcards

1
Q

What is another name for Primary Chronic Adrenocortical Insufficiency?

A

Addison’s Disease. Called primary because it affects the end organ (adrenal gland)

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2
Q

What causes Addison’s Disease?

A

Atrophy (auto immune?) or destruction of the adrenal cortex by metastatic carcinoma or infection.

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3
Q

What is deficient in Addison’s Disease?

A

Cortisol and aldosterone production

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4
Q

What are some symptoms of Addison’s Disease?

A

Weakness, Weight loss, anorexia, GI disturbance
Hyperpigmentation
Hypoglycemia, hyponatremia, hyperkalemia

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5
Q

What causes hyper pigmentation in Addison’s Disease?

A

Loss of negative feedback means more ACTH release activates the melanocyte 1 receptor which leads to hyperpigmentation

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6
Q

What causes hyponatremia in Addison’s Disease?

A

You don’t have enough Aldosterone bringing sodium back at the expense of potassium, so hyponatremia and hyperkalemia

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7
Q

What causes hypoglycemia in Addison’s Disease?

A

Glucocorticoids cause gluconeogenesis, so you have less cortisol in the blood with Addison’s = less glucose

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8
Q

What causes Secondary Chronic Adrenocortical Insufficiency?

A

Deficient cortisol production due to decreased ACTH secretion

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9
Q

Do you get hyper pigmentation in Secondary Chronic Adrenocortical Insufficiency?

A

No because you are not releasing ACTH

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10
Q

How do you diagnose Secondary Chronic Adrenocortical Insufficiency?

A

Infuse ACTH and see if it causes stimulation of cortisol production

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11
Q

What is the treatment for both Primary (Addison’s) and Secondary Adrenocortical Insufficiency?

A

Cortisol replacement therapy

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12
Q

Which has milder symptoms, Primary (Addison’s) or Secondary Adrenocortical Insufficiency?

A

Secondary. Milder symptoms than Addison’s - less electrolyte imbalance and no hyperpigmentation

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13
Q

What causes Acute Adrenocortical Insufficiency?

A

Rapid onset of adrenal insufficiency - often caused by an abrupt withdrawal of high doses of exogenous corticosteroids.

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14
Q

What are the symptoms of Acute Adrenocortical Insufficiency?

A

Weakness, GI disturbances, dehydration, hypotension

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15
Q

What is the treatment of Acute Adrenocortical Insufficiency?

A

STAT replacement of salt, glucose and water along with IV cortisol

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