Addison's Disease Flashcards

(30 cards)

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
What is secondary adrenal insufficiency due to?
Damage to the pituitary gland
26
What is the main cause of secondary adrenal insufficiency?
Sheehan's syndrome
27
What is tertiary adrenal insufficiency?
Inadequate CRH from the hypothalamus
28
What is tertiary adrenal insufficiency due to?
A patient taking long term steroids
29
What is the most common cause in the UK of hypoadrenalism?
Autoimmune destruction of the adrenal gland
30
What can occur in women with addisons?
Loss of pubic hair