Adrenocortical insufficiency

Question 1

Primary acute adrenocortical insufficiency - what is it?`

Answer 1

An emergency - due to body’s inability to rise steroid secretion to deal with stress

Question 2

Primary acute adrenocortical insufficiency - causes - 4

Answer 2

1. A sudden stop of steroid therapy
2. Massive adrenal bleed. can be a complication of a bacterial infection.
3. Childbirth complication
4. Patients receiving anti thrombotic drugs\ DIC

Question 3

Waterhouse-Friderichsen syndrome - what is it?

Answer 3

Progressive BP lose leading to shock

Question 4

Waterhouse-Friderichsen syndrome - why?

Answer 4

adrenal stop functioning due to massive bleeding. Must be treated immediately

Question 5

Waterhouse-Friderichsen syndrome - Morphology - 2

Answer 5

Macro - adrenal look like blood sack.

Micro - left over epithelium and blood everywhere

Question 6

Primary chronic adrenocortical insufficiency - causes - 4

Answer 6

1. Auto - immune Adrenalitis - mostly in devloped countries. lymphocytic invasion of cortex.
2. Chronic infection - mostly in developing countries, TB, AIDS, CMV, micobacteria. TB will show grnuloma.
3. Metastasis - usually from lung
4. Genetic disease - congenital hipoplasia, .adrenoleukpdystrophy

Question 7

Primary chronic adrenocortical insufficiency - symptoms - 6

Answer 7

will only apear after 90% of the tissue is damaged

1. progressive weakness
2. GI symptoms
3. hyperpigmention
4. hyperklemia\ hyponetrmia
5. decreased BP
6. hypoglycemia.

Question 8

Secondary adrenocortical insufficiency - why

Answer 8

Due to problems with hypothalamus hipophisis

Question 9

Secondary adrenocortical insufficiency - sypmtoms

Answer 9

same exept - no hyper pigment .no changes in aldosterone