Primary adrenal insufficiency - Addison's Flashcards
1
Q
what is ‘addison’s disease’?
A
- disorder of the adrenal glands
- leads to decreased production of adrenocortical hormones
- glucocorticoids
- mineralcorticoids
- adrenal androgens
2
Q
Main cause of addison’s disease?
A
- autoimmune adrenalitis in developed world
2. TB in worldwide
3
Q
Name 3 causes of ‘primary adrenal insufficiency’
A
- autoimmune adrenalitis
- Infection - tuberculosis
- Adrenal hemorrhage - waterhouse-friderichsen syndrome
- infiltration of the adrenal glands
- tumors
- hemochromatosis
4
Q
what is ‘waterhouse-friderichsen syndrome
A
massive adrenal haemoorhage
5
Q
describe the pathophysiology of primary adrenal insufficiency?
A
- Damage to adrenal gland
- hypoandrogenism
hypoaldosteronism
hypocortisolism - High ACTH release by negative feedback
6
Q
why does primary adrenal insufficiency cause hyperpigmentation?
A
- excess ACTH
- ACTH is precursor for POMC which become melanocyte stimulating hormone (MSH)
- high MSH and hyperpigmentation of skin
7
Q
hypoaldosteronism - clinical features
A
hypotension
8
Q
hypoaldosteronism - lab findings
A
- hyponatremia
- hyperkalaemia
- metabolic acidosis
9
Q
hypocortisolism - clinical features
A
- weight loss
- fatigue/ lethargy
- GI = N + V + D
- orthostatic hypotention
10
Q
hypocortisolism - lab finding
A
- hypoglycemia
2. hyponatremia
11
Q
hypoandrogenism - clinical features
A
- loss of lbido
2. loss of axillary and pubic hair
12
Q
hypoandrogenism - lab findings
A
- low DHEA-S
13
Q
Elevated ACTH - clinical features
A
Hyperpigmentation of areas
14
Q
Elevated ACTH - lab findings
A
High MSH
15
Q
primary adrenal insufficiency - treatment
A
- Glucocorticoid replacement
- Hydrocortisone - Mineralcorticoid replacement
- Fludrocortisone
