Endocrinology Flashcards
Addison’s disease is?
Primary adrenal insufficiency
How do labs look for Addison’s Disease?
Increased ACTH
Decrease cortisol
Hyponatremia
Hyperkalemia
What is the MC cause of Addison’s?
autoimmune destruction
What is the MC cause Addison’s worldwide?
TB, HIV
What labs are seen in Secondary adrenal insufficiency?
Decrease ACTH
Decrease cortisol
Cause of secondary adrenal insufficiency?
pituitary macroadenoma or central nervous system tumor
No increase in ACTH after CRH injection is what?
Secondary adrenal insufficiency
No increase in cortisol level after ACTH stimulation test is what?
Primary adrenal insufficiency (Addison’s Disease)
What does the labs for tertiary adrenal insufficiency look like?
decrease cortisol
normal aldosterone
ACTH levels increase after CRH injection
Tertiary adrenal insufficiency
What is the MC cause of tertiary adrenal insufficiency?
sudden withdrawal of glucocorticoid therapy
What is the mechanism of Addison’s disease?
destruction of adrenal cortex resulting in loss of cortisol production
What is the screening test for Addison’s disease?
High dose ACTH (cosyntropin) stimulation test
What is the treatment for Addison’s disease?
Glucocorticoids + Mineralocorticoid (Hydrocortisone + Fludrocortisone)
What is the treatment of 2ndry adrenal insufficiency?
Glucocorticoids (Hydrocortisone 1st line, Prednisone, Dexamethasone)
What is the treatment for Adrenal (Addisonian) Crisis?
IV fluids, IV hydrocortisone, glucose,
What symptoms are seen in Addison’s?
Hyperpigmentation, Orthostatic hypotension (syncope, dizziness), hyponatremia, hyperkalemia, metabolic acidosis, hypoglycemia, decrease sex hormones in women (loss of libido, amenorrhea, loss of hair)
Mechanism of Cushing Syndrome?
s/s due to prolonged exposure to excess cortisol
What are symptoms seen in Cushing?
buffalo hump, moon facies, pigmented striae, obesity, hypertension, hypokalema
Diagnosis of Cushing?
Dexamethasone supression test
Suppression of cortisol =
Cushing’s disease
No suppression=
Cushing’s syndrome
Treatment for Cushing disease?
Transsphenoidal surgery
What two medications can be used if a adrenal tumor can’t be removed?
Ketoconazole or Metyrapone
4 Medications that cause Addison’s?
Ketocanzole, Rifampin, Phenytoin, Barbiturates
What causes Type I DM?
Autoimmune