adrenals Flashcards
hypoadrenalism: explain the basis of the management of syndromes of adrenal insufficiency (including Addisons disease, pituitary-dependent (secondary) adrenal insufficiency, acute adrenal insufficiency and congenital adrenal hyperplasia); explain what protective measures should be undertaken for patients with adrenocortical insufficiency
what is Addison’s disease
primary hypoadrenalism due to issue with adrenal gland meaning it cannot produce sufficient steroid hormones
expected blood test results for Addison’s including time
low Na+ and high K+; 9am cortisol levels low (should be high), ACTH levels high
Addison’s test to measure cortisol response to stess and confirm diagnosis
short synATCHen test by giving 250ug synACTHen IM and measuring cortisol response
typical 9am Addison’s patient cortisol levels, and levels at 9:30am after giving 250ug synACTHen IM
9am: 100 (270-900); 9:30am: 150 (>600), showing in presence of high ACTH they cannot produce cortisol
what else stimulates aldosterone release besides CRH and ACTH in hypothalamo-pituitary-adrenal axis
RAAS: angiotensinogen converted to angiotensin I in liver by renin -> angiotensin I converted to angiotensin II in lungs by ACE -> increase in aldosterone production and release
what 4 things stimulate RAAS
hyperkalaemia, hyponatraemia, reduced renal blood flow, B1-adrenoceptor stimulation
