Addison's Disease and Crisis: Causes, Symptoms, and Consequences
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Questions and Answers

What is the primary underlying cause of an Addisonian crisis?

  • Low levels of insulin
  • High levels of adrenaline
  • Excessive cortisol levels
  • Inadequate cortisol levels (correct)

What is the effect of cortisol on systemic adrenaline in the vascular shunting exercise?

  • Cortisol decreases systemic adrenaline
  • Cortisol potentiates systemic adrenaline (correct)
  • Cortisol blocks systemic adrenaline
  • Cortisol has no effect on systemic adrenaline

What is a common clinical feature of Addison's disease?

  • Hyperglycaemia
  • Tachycardia
  • Hypotension (correct)
  • Hypertension

What is the purpose of the Short Synacthen test in diagnosing Addison's disease?

<p>To assess the function of the adrenal glands (B)</p> Signup and view all the answers

What is the typical dosage of hydrocortisone used to manage Addison's disease?

<p>20mg mane &amp; 10mg nocte (D)</p> Signup and view all the answers

What is a possible cause of secondary hypoadrenalism?

<p>Hypothalamic-pituitary axis disease (C)</p> Signup and view all the answers

What is the effect of a growth hormone deficiency in childhood?

<p>Pituitary dwarf (D)</p> Signup and view all the answers

What is the primary function of growth hormone in childhood?

<p>Regulating growth and development (A)</p> Signup and view all the answers

What is the term for excessive growth hormone production in adulthood?

<p>Acromegaly (D)</p> Signup and view all the answers

What is the most common cause of acromegaly?

<p>Pituitary tumour (C)</p> Signup and view all the answers

What is the term for a visual field defect that can result from acromegaly?

<p>Bitemporal hemianopia (D)</p> Signup and view all the answers

What is the primary mechanism of action of the thyroid?

<p>TRF stimulates TSH, which stimulates T4 and T3 production (C)</p> Signup and view all the answers

What is the primary disease of hypothyroidism?

<p>Thyroid tissue (C)</p> Signup and view all the answers

What is the most common aetiology of hypothyroidism?

<p>Atrophic autoimmune hypothyroidism (D)</p> Signup and view all the answers

What is the primary treatment for hypothyroidism?

<p>Lifelong replacement therapy with thyroxine (A)</p> Signup and view all the answers

What is a common clinical feature of hypothyroidism?

<p>Macroglossia (A)</p> Signup and view all the answers

What is the primary reason Addisonian patients are unable to respond appropriately in stressful situations?

<p>They cannot produce enough cortisol to accompany the adrenaline to facilitate vascular shunting. (D)</p> Signup and view all the answers

What is recommended for a steroid-dependent Addison's disease patient before major dental surgery like an extraction?

<p>100mg hydrocortisone IM just before anaesthesia (D)</p> Signup and view all the answers

What is the primary function of mineralocorticoids in the body?

<p>To regulate electrolyte balance and blood pressure (C)</p> Signup and view all the answers

What is the term for excess aldosterone production in the adrenal gland?

<p>Hyperaldosteronism (A)</p> Signup and view all the answers

What are the consequences of primary adrenal adenoma in Conn's syndrome?

<p>Hypokalemia, excess fluid retention, and secondary hypertension (A)</p> Signup and view all the answers

What is the mechanism of secondary hyperaldosteronism in Conn's syndrome?

<p>Excess stimulation through the renin-angiotensin axis (B)</p> Signup and view all the answers

What is the typical cause of congenital adrenal hyperplasia?

<p>Defect in steroid-21 hydroxylase enzyme (D)</p> Signup and view all the answers

What occurs to young boys with congenital adrenal hyperplasia?

<p>Precocious puberty (B)</p> Signup and view all the answers

What is the recommended management for hypertension in Conn's syndrome due to adrenal hyperplasia?

<p>Hypertension can be combatted using spironolactone (C)</p> Signup and view all the answers

What is the typical presentation of congenital adrenal hyperplasia in young females?

<p>Infertile and hirsute young hypotensive females with salt-losing kidneys (C)</p> Signup and view all the answers

What is a common symptom of severe hypothyroidism?

<p>Hypothermia (C)</p> Signup and view all the answers

What is the most common cause of hyperthyroidism?

<p>Grave's disease (D)</p> Signup and view all the answers

What is the primary function of parathyroid hormone?

<p>Regulation of serum calcium levels (C)</p> Signup and view all the answers

What is the primary cause of primary hyperparathyroidism?

<p>Adenoma in the parathyroid gland (D)</p> Signup and view all the answers

What is a common presentation of primary hyperparathyroidism?

<p>Renal stones (C)</p> Signup and view all the answers

What is a characteristic feature of the eye in Grave's disease?

<p>Exophthalmos (D)</p> Signup and view all the answers

What is the purpose of a CT scan in Grave's disease?

<p>To exclude retro-orbital tumor (C)</p> Signup and view all the answers

What is the role of beta blockers in the management of hyperthyroidism?

<p>To control sympathetic symptoms (C)</p> Signup and view all the answers

What is the most common gender affected by goitre?

<p>Female (B)</p> Signup and view all the answers

What is the cause of dysphagia or stridor in goitre?

<p>Pressure on the larynx (B)</p> Signup and view all the answers

What is the primary mechanism by which cortisol influences the body's response to stress?

<p>By potentiating systemic adrenaline in the vascular shunting exercise (C)</p> Signup and view all the answers

What is the most common electrolyte imbalance observed in patients with Addison's disease?

<p>Hyponatremia and hyperkalemia (A)</p> Signup and view all the answers

What is the primary purpose of fludrocortisone in the management of Addison's disease?

<p>To regulate electrolyte balances and blood pressure (A)</p> Signup and view all the answers

What is the most common presentation of Addison's disease in patients?

<p>Insidious development of lethargy, anorexia, and weight loss (A)</p> Signup and view all the answers

What is the primary role of the Short Synacthen test in diagnosing Addison's disease?

<p>To measure cortisol levels in response to ACTH stimulation (C)</p> Signup and view all the answers

What is the primary underlying cause of secondary hypoadrenalism?

<p>Hypothalamic-pituitary axis disease (B)</p> Signup and view all the answers

What is the result of a growth hormone excess in childhood?

<p>Gigantism (A)</p> Signup and view all the answers

What is the primary cause of visual field defects in acromegaly?

<p>Adenoma pressing on the optic chiasm (C)</p> Signup and view all the answers

What is the term for the condition where the body's bones and tissues grow excessively due to an overproduction of growth hormone in adulthood?

<p>Acromegaly (D)</p> Signup and view all the answers

What is the primary function of TSH in the mechanism of action of the thyroid?

<p>Driving the production of T4 and T3 (C)</p> Signup and view all the answers

What is the most common variation of hypothyroidism?

<p>Atrophic autoimmune hypothyroidism (B)</p> Signup and view all the answers

What is the purpose of the TSH test in managing hypothyroidism?

<p>To monitor the effectiveness of thyroxine replacement therapy (A)</p> Signup and view all the answers

What is the result of a growth hormone deficiency in childhood?

<p>Pituitary dwarfism (B)</p> Signup and view all the answers

What is the primary mechanism of action of octreotide in managing acromegaly?

<p>Shrinking inoperable tumours to resectable proportions (B)</p> Signup and view all the answers

What is the result of a benign anterior pituitary acidophil adenoma in adulthood?

<p>Acromegaly (D)</p> Signup and view all the answers

What is the primary purpose of glucose tolerance test in diagnosing acromegaly?

<p>To test the body's ability to suppress growth hormone production (C)</p> Signup and view all the answers

What is the primary cause of Graves' disease?

<p>IgG autoantibody acting against TSH receptors (C)</p> Signup and view all the answers

What is the primary mechanism of action of carbimazole in the management of hyperthyroidism?

<p>Inhibiting the formation of thyroid hormones (C)</p> Signup and view all the answers

What is the primary indication for radioiodine therapy in the management of hyperthyroidism?

<p>Relapsed hyperthyroidism after drug therapy (C)</p> Signup and view all the answers

What is the primary effect of hyperparathyroidism on the bone?

<p>Generalized porosis of bone (D)</p> Signup and view all the answers

What is the primary mechanism of action of parathyroid hormone in the regulation of serum calcium levels?

<p>Acting with vitamin D to defend serum ionized calcium (C)</p> Signup and view all the answers

What is the primary underlying cause of primary hyperparathyroidism?

<p>Unstimulated PTH excess by adenoma inappropriate to serum calcium levels (C)</p> Signup and view all the answers

What is the primary reason for the use of beta blockers in the management of hyperthyroidism?

<p>To control sympathetic symptoms (D)</p> Signup and view all the answers

What is the primary cause of dysphagia or stridor in patients with goitre?

<p>Pressure on the larynx (B)</p> Signup and view all the answers

What is the primary indication for surgical management of goitre?

<p>Pressure symptoms such as dysphagia or stridor (A)</p> Signup and view all the answers

What is the primary biochemical feature of primary hyperparathyroidism?

<p>Elevated serum calcium levels and elevated PTH (C)</p> Signup and view all the answers

What is the primary function of mineralocorticoids in the body?

<p>To promote renal sodium reabsorption and potassium excretion (C)</p> Signup and view all the answers

What is the recommended management for a steroid-dependent Addison's disease patient before dental surgery like a root canal?

<p>Double normal dose of hydrocortisone one hour prior to surgery (D)</p> Signup and view all the answers

What is the typical cause of congenital adrenal hyperplasia?

<p>A congenital defect in steroid synthesis, typically caused by a defect in the steroid-21 hydroxylase enzyme (D)</p> Signup and view all the answers

What is the primary mechanism of action of congenital adrenal hyperplasia?

<p>17-hydroxylase progesterone accumulates and is processed to androgens in the zona fasciculata (B)</p> Signup and view all the answers

What is the primary underlying cause of Conn's syndrome?

<p>A primary adrenal adenoma or hyperplasia (D)</p> Signup and view all the answers

What is the recommended management for hypertension in Conn's syndrome due to adrenal hyperplasia?

<p>Medication with spironolactone, an aldosterone antagonist (A)</p> Signup and view all the answers

What is the primary consequence of primary adrenal adenoma in Conn's syndrome?

<p>Hypokalemia and hypertension (D)</p> Signup and view all the answers

What is the term for excess aldosterone production in the adrenal gland?

<p>Hyperaldosteronism (B)</p> Signup and view all the answers

What is the primary mechanism of action of secondary hyperaldosteronism in Conn's syndrome?

<p>Excess stimulation through the renin-angiotensin axis (A)</p> Signup and view all the answers

What is the group of people more commonly affected by congenital adrenal hyperplasia?

<p>Infertile and hirsute young hypotensive females with salt-losing kidneys (D)</p> Signup and view all the answers

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