Addisons disease

Question 1

what is addisons

Answer 1

decraesed production of adrenocortical hormones - glucocorticoids, mineralocorticoids and adrenal androgens

particulary cortisol and aldosterone

Question 2

what is the most common cause of addisosn

Answer 2

autoimmune adrenalitis

Question 3

what does addisons involve

Answer 3

destruction of entire adrenal cortex

Question 4

investigations

Answer 4

adrenal autoantibodies

low na+
increased k+

may be hypoglycaemic

short synacthen test

acth levels very high

increased renin, decreased aldosterone

Question 5

clincial presentation of addisosn

Answer 5

weakness fatigue anorexia weight loss diarrhoea dizziness and low bp
abdominal paon
skin pigmentation
look tanned

Question 6

pharmacological management of addisons

Answer 6

• Hydrocortisone as cortisol replacement
  
  • If unwell IV first
  • Usually 15-30mg PO daily in divided doses
  • Try and mimic diurnal rhyrhm (higher dose in morning)
• Fludrocortisone as aldosterone replacement
  
  • Careful monitoring of BP and K+

Question 7

symptomaticness

Answer 7

90% of adrenal cortex destroyed before symptomatic