Addison's Disease Flashcards

1
Q

What is Addison’s disease?

A

Autoimmune destruction of the adrenal glands

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2
Q

What is Addison’s a primary form of?

A

Primary adrenal insufficiency

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3
Q

What is there a reduced production of in Addison’s?

A

Cortisol

Aldosterone

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4
Q

What is the most common cause of Addison’s worldwide?

A

Tuberculosis

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5
Q

How does Addison’s present?

A
Trim
Tanned
Tired
Tearful
Pigmented palmar creases
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6
Q

What is an alternative way that Addison’s can present?

A

Nausea
Vomiting
Weakness
Weight loss

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7
Q

Why does someone with Addison’s crave salt?

A

Due to hyponatraemia

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8
Q

What is the first line investigation for Addison’s

?

A

Short Synacthen test

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9
Q

What is the short synactehn test?

A

ACTH stimulation test

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10
Q

What does a Short synacthen test involve?

A

Measure plasma cortisol before giving it

Measure cortisol 30 minutes after giving it

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11
Q

What investigation would you do if ACTH not available?

A

9am serum cortisol

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12
Q

What antibody can you test for in Addison’s?

A

21-hydroxylase antibody

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13
Q

What electrolyte imbalances would you expect in Addison’s?

A

Hyponatraemia
Hyperkalaemia
Hypercalcaemia
Hypoglycaemia
Metabolic acidosis

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14
Q

What is sometimes the only sign of Addison’s?

A

Hyponatraemia

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15
Q

What is the management of Addison’s?

A

Hydrocortisone

Fludrocortisone

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16
Q

What is hydrocortisone?

A

A glucocorticoid

17
Q

How should the hydrocortisone be administered?

A

Majority of it should be given in the first part of the day

18
Q

What is fludrocortisone?

A

Mineralocorticoid

19
Q

What is the function of fludrocortisone?

A

Hypotension
Hyponatraemia
Hyperkalaemia

20
Q

If the patient is ill, how should the treatment be changed?

A

Double the hydrocortisone

Keep the fludrocortisone the same

21
Q

What is an Addisonian crisis?

A

The absence of steroid hormone leads to life-threatening disease

22
Q

How does an Addisonian crisis present?

A

Reduced consciousness- shock, collapse and pyrexia
Hyponatraemia, Hyperkalaemia, Hypercalcaemia

23
Q

What is the management of an Addisonian crisis?

A

IV/IM hydrocortisone

100mg every 6 hours

24
Q

What is secondary adrenal insufficiency?

A

Inadequate ACTH stimulating the adrenal gland

25
Q

What is secondary adrenal insufficiency due to?

A

Damage to the pituitary gland

26
Q

What is the main cause of secondary adrenal insufficiency?

A

Sheehan’s syndrome

27
Q

What is tertiary adrenal insufficiency?

A

Inadequate CRH from the hypothalamus

28
Q

What is tertiary adrenal insufficiency due to?

A

A patient taking long term steroids

29
Q

What is the most common cause in the UK of hypoadrenalism?

A

Autoimmune destruction of the adrenal gland

30
Q

What can occur in women with addisons?

A

Loss of pubic hair