Steroid conditions

Question 1

What is adrenal insufficiency?

Answer 1

Adrenal insufficiency (addisons): adrenal gland can’t make enough cortisol + aldosterone

Question 2

What is the treatment for adrenal insufficiency?

Answer 2

• Hydrocortisone (2 doses - larger in morning)
• Fludrocortisone

Question 3

What are the symptoms and treatment for adrenal crises?

Answer 3

• IV hydrocortisone
• Low BP, dizzy, fever, shivering, tiredness, muscle aches, stomach ache

Question 4

What are the sick day rules?

Answer 4

Fever or infection requiring abx:
- 2x daily dose

Persistent vomiting from GI viral illness: IM/IV

Hospital: vom or di persists

Question 5

What is cushing syndrome?

Answer 5

Set of symptoms caused by high cortisol levels

Question 6

What are the signs of cushing syndrome?

Answer 6

• Emotional disturbance
• Fatty deposits in abdomen + neck
• Hypertension
• Skin ulcer
• Osteoporosis
• Muscle wasting
• Moon face

Question 7

What is the treatment for cushing syndrome?

Answer 7

Caused by corticosteroids: review treatment

Caused by tumour: surgically remove or manage with:
- Ketoconazole
- Counsel: report signs of liver disorder (persistent vom, abdominal pain, dark urine)
- Report signs of adrenal insufficiency (Hypotension, fatigue, anorexia, hyponatraemia, hyperkalaemia, hypoglycaemia