Steriod hormone disorders

Question 1

Adrenal cortex zones

Answer 1

Zona glomerulosa (mineralocorticoids)
Zona fasciculata (glucocorticoids)
Zona reticularis (sex hormones)

Question 2

Addisons disease

Answer 2

Inadequate adrenocortical function:
Destruction of the adrenal cortex (primary or Addison’s
disease)
Disordered pituitary and hypothalamic function
(secondary)
Most commonly due to suppression of hypothalamic/pituitary ACTH release by exogenous steroids
(e.g. oral, topical or inhaled glucocorticoids taken for asthma, rheumatoid arthritis, eczema etc)

Question 3

Treating addisons disease

Answer 3

Hydrocortisone (to replace cortisol)
Fludrocortisone (to replace aldosterone)
Occasionally DHEA (to replace DHEA/sex steroids, esp in women with low libido etc)
Consider screening for other autoimmune conditions e.g. primary hypothyroidism
‘Adrenal crisis’ occurs if patients do not increase their steroid doses appropriately or if they miss them
Crisis can be life-threatening