Addissons Disease

Question 1

What is Addison’s disease?
A. Secondary adrenal insufficiency
B. Excess cortisol production
C. Primary adrenal insufficiency
D. Pituitary hormone deficiency

Answer 1

Correct answer: Primary adrenal insufficiency. Explanation: Addison’s disease is caused by failure of the adrenal glands themselves.

Question 2

What is the underlying pathology in Addison’s disease?
A. Pituitary failure
B. Hypothalamic dysfunction
C. Destruction of the adrenal cortex
D. Renal hormone resistance

Answer 2

Correct answer: Destruction of the adrenal cortex. Explanation: Damage to the adrenal cortex leads to reduced hormone production.

Question 3

Which hormones are reduced in Addison’s disease?
A. Mineralocorticoids only
B. Glucocorticoids and androgens
C. Catecholamines
D. Aldosterone only

Answer 3

Correct answer: Glucocorticoids and androgens. Explanation: Destruction of the adrenal cortex reduces cortisol and androgen production.

Question 4

Which cardiovascular symptom is commonly seen in Addison’s disease?
A. Hypertension
B. Tachycardia only
C. Postural dizziness and hypotension
D. Peripheral oedema

Answer 4

Correct answer: Postural dizziness and hypotension. Explanation: Reduced aldosterone causes low blood pressure.

Question 5

Which musculoskeletal symptom is associated with Addison’s disease?
A. Muscle hypertrophy
B. Weakness and cramps
C. Bone fractures
D. Tremor

Answer 5

Correct answer: Weakness and cramps. Explanation: Electrolyte imbalance and cortisol deficiency cause muscle symptoms.

Question 6

Which gastrointestinal symptom may suggest Addison’s disease?
A. Constipation
B. Weight gain
C. Weight loss and nausea
D. Dysphagia

Answer 6

Correct answer: Weight loss and nausea. Explanation: GI disturbances are common due to cortisol deficiency.

Question 7

Salt craving in Addison’s disease is caused by deficiency of which hormone?
A. Cortisol
B. Androgens
C. Aldosterone
D. Adrenaline

Answer 7

Correct answer: Aldosterone. Explanation: Aldosterone deficiency leads to sodium loss, causing salt craving.

Question 8

What skin change is characteristic of Addison’s disease?
A. Pallor
B. Vitiligo
C. Hyperpigmentation
D. Urticaria

Answer 8

Correct answer: Hyperpigmentation. Explanation: Increased ACTH stimulates melanin production.

Question 9

Fatigue in Addison’s disease is primarily due to deficiency of which hormone?
A. Aldosterone
B. Cortisol
C. Insulin
D. Thyroxine

Answer 9

Correct answer: Cortisol. Explanation: Cortisol deficiency causes fatigue and low energy.

Question 10

Which hormones must be replaced in the long-term management of Addison’s disease?
A. Glucocorticoids only
B. Mineralocorticoids only
C. Both glucocorticoids and mineralocorticoids
D. Androgens only

Answer 10

Correct answer: Both glucocorticoids and mineralocorticoids. Explanation: Both hormone pathways are deficient in Addison’s disease.

Question 11

What is the first-line glucocorticoid used to treat Addison’s disease?
A. Prednisolone
B. Dexamethasone
C. Hydrocortisone
D. Fludrocortisone

Answer 11

Correct answer: Hydrocortisone. Explanation: Hydrocortisone is the preferred first-line glucocorticoid.

Question 12

Which glucocorticoid may be used as an alternative to hydrocortisone?
A. Dexamethasone
B. Prednisolone
C. Betamethasone
D. Fluticasone

Answer 12

Correct answer: Prednisolone. Explanation: Prednisolone can be used if hydrocortisone is unsuitable.

Question 13

Which mineralocorticoid is used in Addison’s disease?
A. Spironolactone
B. Eplerenone
C. Fludrocortisone
D. Aldactone

Answer 13

Correct answer: Fludrocortisone. Explanation: Fludrocortisone replaces aldosterone.

Question 14

What is an adrenal crisis?
A. Chronic worsening of symptoms
B. Mild electrolyte imbalance
C. Acute life-threatening cortisol deficiency
D. Excess steroid exposure

Answer 14

Correct answer: Acute life-threatening cortisol deficiency. Explanation: Adrenal crisis is a medical emergency.

Question 15

What is the immediate management of adrenal crisis?
A. Oral hydrocortisone
B. IM or IV hydrocortisone and IV saline
C. Fludrocortisone only
D. Oral prednisolone

Answer 15

Correct answer: IM or IV hydrocortisone and IV saline. Explanation: Rapid steroid replacement and fluid resuscitation are required.

Question 16

Where should a patient with adrenal crisis be managed?
A. At home
B. GP surgery
C. Emergency hospital admission
D. Outpatient clinic

Answer 16

Correct answer: Emergency hospital admission. Explanation: Adrenal crisis requires urgent hospital treatment.