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</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</p> Signup and view all the answers

    What is a possible cause of secondary hypoadrenalism?

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

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

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

    What is the primary function of growth hormone in childhood?

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

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

    <p>Acromegaly</p> Signup and view all the answers

    What is the most common cause of acromegaly?

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

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

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

    What is the primary disease of hypothyroidism?

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

    What is the most common aetiology of hypothyroidism?

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

    What is the primary treatment for hypothyroidism?

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

    What is a common clinical feature of hypothyroidism?

    <p>Macroglossia</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.</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</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</p> Signup and view all the answers

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

    <p>Hyperaldosteronism</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</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</p> Signup and view all the answers

    What is the typical cause of congenital adrenal hyperplasia?

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

    What occurs to young boys with congenital adrenal hyperplasia?

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

    What is a common symptom of severe hypothyroidism?

    <p>Hypothermia</p> Signup and view all the answers

    What is the most common cause of hyperthyroidism?

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

    What is the primary function of parathyroid hormone?

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

    What is the primary cause of primary hyperparathyroidism?

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

    What is a common presentation of primary hyperparathyroidism?

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

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

    <p>Exophthalmos</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</p> Signup and view all the answers

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

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

    What is the most common gender affected by goitre?

    <p>Female</p> Signup and view all the answers

    What is the cause of dysphagia or stridor in goitre?

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

    What is the primary underlying cause of secondary hypoadrenalism?

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

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

    <p>Gigantism</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</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</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</p> Signup and view all the answers

    What is the most common variation of hypothyroidism?

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

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

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

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

    <p>Acromegaly</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</p> Signup and view all the answers

    What is the primary cause of Graves' disease?

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

    What is the primary effect of hyperparathyroidism on the bone?

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

    What is the primary biochemical feature of primary hyperparathyroidism?

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

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

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

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

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

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

    <p>Hyperaldosteronism</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</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</p> Signup and view all the answers

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