Addison's Disease Flashcards
(27 cards)
What is Addison’s disease?
A rare disorder caused by destruction of the adrenal cortex, leading to reduced production of cortisol, aldosterone, and adrenal androgens.
What hormones are deficient in Addison’s disease?
Glucocorticoids (cortisol), mineralocorticoids (aldosterone), and adrenal androgens (DHEA).
What is the most common cause of Addison’s disease in Western countries?
Autoimmune adrenalitis (about 90% of cases).
Name other causes of primary adrenal insufficiency.
Congenital adrenal hyperplasia, infections like tuberculosis.
What conditions can cause adrenal insufficiency but are not Addison’s disease?
Long-term corticosteroid use, pituitary or hypothalamic disorders.
Why is diagnosis of Addison’s disease often delayed?
Symptoms are non-specific and overlap with many common conditions.
What are the signs of an adrenal crisis?
Hypotension, hypovolaemic shock, vomiting, abdominal pain, reduced consciousness.
What should you do if adrenal crisis is suspected?
Administer IM/IV hydrocortisone immediately and arrange emergency admission.
List some non-specific symptoms of Addison’s disease.
Fatigue, hyperpigmentation, GI symptoms, salt craving, postural hypotension, muscle cramps.
Which comorbidities might suggest Addison’s disease?
Hypothyroidism worsening with thyroxine, type 1 diabetes with unexplained hypos, other autoimmune diseases.
What blood biochemistry findings suggest Addison’s disease?
Low sodium and high potassium
What is the significance of 9 am cortisol levels?
<100 nmol/L: Admit — adrenal insufficiency likely
100–500 nmol/L: Refer to endocrinology
500 nmol/L: Adrenal insufficiency unlikely
What test confirms the diagnosis of Addison’s disease?
Synacthen® (ACTH stimulation) test.
Is Addison’s disease fatal if untreated?
Yes — lifelong treatment is essential.
What is the standard treatment for Addison’s disease?
Hydrocortisone for glucocorticoid replacement
Fludrocortisone for mineralocorticoid replacement
DHEA (optional, specialist-prescribed)
What should patients with Addison’s disease carry at all times?
Steroid treatment card, MedicAlert ID, emergency hydrocortisone.
When should corticosteroid doses be increased in Addison’s disease?
During illness, injury, or surgery (stressful situations).
What is the usual adult daily dose of hydrocortisone?
15–25 mg in divided doses.
What factors influence hydrocortisone dosage?
Body weight, metabolism, and absorption.
What is a common three-dose hydrocortisone schedule for adults?
10 mg on waking, 5 mg at noon, and 5 mg in the early evening.
What is a possible two-dose hydrocortisone schedule?
15 mg in the morning and 10 mg in the afternoon or early evening.
What is the main drawback of a two-dose glucocorticoid schedule?
It may cause greater variation in cortisol levels.
What is the usual adult dose range for fludrocortisone?
50–200 micrograms per day.
What factors affect fludrocortisone dosage?
Metabolism, exercise levels, and age.
