Addison's disease

Question 1

Chronic

Answer 1

1’ adrenal insufficiency due to adrenal atrophy, destruction of disease (autoimmune, TB, met)

Question 2

Pathophys

Answer 2

Deficiency of aldosterone/cortisol causing

1) hypotension (hyponatremic volume contraction),
2) hyperkalemia,
3) acidosis and
4) skin pigmentation (due to high MSH, by product of ACTH production from POMC)

Question 3

Characterized by

Answer 3

1) Adrenal atrophy
2) Absence of hormone production
3) All 3 cortical divisions involved (spares medulla)

Question 4

How to distinguish from 2’ adrenal insufficiency

Answer 4

Low pituitary ACTH production,

so NO hyperpigmentation and NO hyperkalemia

Question 5

Waterhouse-Friderichsen syndrome

Answer 5

Acute 1’ adrenal insufficiency

Adrenal hemorrhage associated with N meningitidis, septicemia, DIC, endotoxic shock.