Addison's Disease

Question 1

what are some causes of Addison’s disease

Answer 1

most common is autoimmune
TB
metastatic carcinoma

Question 2

what is Addison’s disease

Answer 2

primary adrenal insufficiency
may be deficient in both aldosterone and cortisol

Question 3

how can Addison’s disease present

Answer 3

aldosterone related:
hypotension (decreased K + Na)
metabolic acidosis
dizziness, postural hypotension, fatigue, craving salt foods

cortisol related:
hypoglycaemia: weakness, confusion, fatigue
hyperpigmentation
anorexia

Question 4

diagnosis of Addison’s disease

Answer 4

ACTH stimulation test
would not see increased aldosterone and cortisol

Question 5

what is secondary and tertiary adrenal insufficiency

Answer 5

secondary: decreased ACTH due to pituitary damage

tertiary: long term steriod use, suppression of CRH release from hypothalamus

Question 6

what is the management of Addison’s disease

Answer 6

hydrocortisone - replaces cortisol

flurocortisol - replaces aldosterone

Question 7

presentation of an adrenal crisis

Answer 7

severe hypotension (can cause shock)
arrythmia
confusion
N+V
dehydration
abdominal and back pain

Question 8

management of an adrenal crisis

Answer 8

IV glucocorticoids (as symptoms related to insufficient cortisol)
IV fluids and dextrose
close monitoring
identify and manage underlying cause