Adrenal insufficiency

Question 1

Addison’s disease results in raised ACTH and low cortisol. True/False?

Answer 1

True

Question 2

What is Addison’s disease?

Answer 2

When the adrenal glands have been damaged, resulting in reduced cortisol and aldosterone secretion.

Question 3

Addison’s disease can also be referred to as primary adrenal insufficiency and the most common cause is due to autoimmunity. True/false?

Answer 3

True

Question 4

What is secondary adrenal insufficiency?

Answer 4

Inadequate ACTH and lack of adrenal gland stimulation leading to low cortisol. Due to loss or damage to pituitary gland.

Question 5

Potential causes of secondary adrenal insufficiency?

Answer 5

Tumours (e.g. pituitary adenoma).
Pituitary surgery
Trauma
Radiotherapy

Question 6

Symptoms of adrenal insufficiency?

Answer 6

Fatigue
Muscle weakness
Muscle cramps
Dizziness and fainting
Thirst and craving
Abdominal pain
Reduced libido

Question 7

Signs of adrenal insufficiency?

Answer 7

Hyperpigmentation (particularly in axillae and palmar creases).
Hypotension on standing

Question 8

Addison’s will present with low potassium and high sodium. True/false?

Answer 8

False, high potassium, low sodium.

Question 9

What test is used to diagnose adrenal insufficiency?

Answer 9

Short synacthen test

Question 10

How is adrenal insufficiency treated?

Answer 10

Replacements steroids in order to bring up to normal levels:

• Fludrocortisone for aldosterone (mineralocorticoid)
• Hydrocortisone for cortisol (glucocorticoid).