Addisons and Cushings

Question 1

Test for Cushings

Answer 1

High dose dexamethasone

Question 2

Outcome of dexa test if pituitary adenoma - think about why

Answer 2

cortisol not supressed
ACTH not suppressed

because the pituitary adenoma is still secreting ACTH

Question 3

Causes of cushings

Answer 3

Pituitary adenoma
Adrenal adenoma

Question 4

Outcome of dexa test if adrenal adenoma - think about why

Answer 4

cortisol not suppressed (adenoma still secreting)
ACTH suppressed (exogenous dexamethasone)

Question 5

Addisons management

Answer 5

2/3 divided doses of hydrocortisone
fludrocortisone

Question 6

Addisons management in a crisis

Answer 6

IM hydrocortisone

Question 7

Addisons management in intercurrent illness

Answer 7

Double hydrocortisone, normal fludrocortisone

Question 8

Symptoms of Addisons

Answer 8

lethargy, weakness, anorexia, nausea & vomiting, weight loss, ‘salt-craving’

Question 9

ABG for Addisons

Answer 9

metabolic acidosis with normal anion gap

Question 10

primary adrenal failure vs secondary adrenal insufficiency

Answer 10

primary -> Addisons
secondary -> pituitary issue