Wk 10: Corticosteroid 2 + 3

Question 1

Outline the investigations for glucocorticoid abnormalities

Answer 1

• Dexamethasone (cushing): 1mg at night

- ACTH (addison): tetracosactide 250 ug IV/IM

Question 2

Outline the pathophysiology of addison

Answer 2

• Destruction of adrenal cortex
• Glucocorticoid, mineralocorticoid + sex steroid red
• Red cortisol = inc CRH + ACTH

Question 3

Addison disease treatment

Answer 3

• Hydrocortisone 100mg IM w/ IV saline 1L

- Glucose if hypoglycemic

Question 4

Outline the replacement regime for addison disease

Answer 4

• Hydrocortisone: 20-30mg daily

- Pred: 7.5mg, 5 waking, 2.5 at 1800

Question 5

Pathopysiology of cushing syndrome

Answer 5

• Inc circulating ACTH from pituitary

- ACTH producing tumors in body w/ glucocorticoid excess

Question 6

Clinical features of cushing syndrom

Answer 6

• Impaired glucose tolerance
• Hypokalaemia
• Thinning of skin
• Moon face

Question 7

Cushing syndrome treatment

Answer 7

• Metyrapone: inhibit cortisone, inc ACTH: 750mg-4g

- Ketoconazole 200mg TDS: antifungal