Circadian rhythms, adrenal insufficiency and management Flashcards
define circadian rhythms
physical, mental and behavioural changes that follow a daily cycle.
what is adrenal insufficiency ?
A condition in which the adrenal glands do not produce adequate amounts of steroid hormone (mainly cortisol).
what are the three types of adrenal insufficiency?
primary- Addison’s disease
secondary- Hypopituitarism
tertiary- suppression of HPA
what are the symptoms of adrenal insufficiency?
Fatigue
Weight loss
Poor recovery from illness
Adrenal crisis
Headache
what past history is significant with adrenal insufficiency?
TB
Post partum bleed
Cancer
what family history is significant with adrenal insufficiency?
Autoimmunity
Congenital disease
what past treatments could is significant adrenal insufficiency?
an steroids
what are the signs visible for adrenal insufficiency?
Pigmentation and pallor
Hypotension
describe the biochemistry for adrenal insufficiency?
Low Na, high K
Eosinophilia
Borderline elevated TSH
what are the primary causes of adrenal insufficiency?
Adrenal antibodies
Very long chain fatty acids
Genetic
what are the secondary causes of adrenal insufficiency?
Any steroids
Imaging
Genetic
what is the treatment goal for adrenal insufficiency?
mirror the normal physiological state
what does the treatment include for adrenal insufficiency?
Replace aldosterone with fludrocortisone (primary AI)
Hydrocortisone 2/3 times daily
what occurs during adrenal crisis?
Hypotension and cardiovascular collapse
Fatigue
Fever
Hypoglycaemia
Hyponatraemia and hyperkalaemia
