Recent

  • Show all results for ""
Addison's Disease: Chronic Primary Adrenocortical Insufficiency
40 Questions
0 Views

Addison's Disease: Chronic Primary Adrenocortical Insufficiency

Created by
@InnocuousWashington

Questions and Answers

What is the primary cause of Addison's disease in developing countries?

  • Hypocortisolism
  • Autoimmune reaction
  • Tuberculosis (correct)
  • Adrenocortical hypofunction

    • What is the term used to describe the destruction or dysfunction of adrenal cortical tissue?

  • Hypocortisolism
  • Chronic primary adrenocortical insufficiency (correct)
  • Adrenocortical hypofunction
  • Adrenal insufficiency

    • What is the term used to describe the failure of the adrenal glands to produce hormones, resulting from injury or surgery to the hypothalamus or pituitary gland?

  • Primary adrenocortical insufficiency
  • Acute adrenal insufficiency
  • Adrenal crisis
  • Secondary adrenocortical insufficiency (correct)

    • What is the leading cause of Addison's disease in developed countries, including the US?

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

    What is the term used to describe the life-threatening complication of inadequately treated Addison's disease?

    <p>Acute addisonian crisis</p> Signup and view all the answers

    What is the significance of Addison's disease?

    <p>It is a hormonal disorder that can be life-threatening if not treated</p> Signup and view all the answers

    Who provided the first detailed clinical description of CPAI?

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

    What is the common term used to describe the ability of patients with Addison's disease to respond to stress?

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

    What is a characteristic of Addisonian crisis?

    <p>Hypotension, hypoglycemia, and hyperkalemia</p> Signup and view all the answers

    What is the most common cause of Addison's disease (AD)?

    <p>Autoimmune adrenal insufficiency</p> Signup and view all the answers

    What is a possible cause of chronic fatigue in patients with AD?

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

    What is a characteristic of autoimmune AD?

    <p>Destruction of the adrenal cortex</p> Signup and view all the answers

    What is a complication of adrenoleukodystrophy?

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

    What is a type of autoimmune disease that can occur in patients with AD?

    <p>Polyglandular autoimmune disease</p> Signup and view all the answers

    What is a feature of localized autoimmune adrenal insufficiency?

    <p>Destruction of only the adrenal cortex</p> Signup and view all the answers

    What is the approximate percentage of cases of AD caused by tuberculosis in developed countries?

    <p>10%</p> Signup and view all the answers

    What is the typical age range for Addison disease to develop in PGAD I patients?

    <p>By 15 years</p> Signup and view all the answers

    Which of the following is NOT a complication of PGAD I?

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

    What is the mode of inheritance of PGAD I?

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

    What is the typical presentation of PGAD II?

    <p>In adulthood with autoimmune disorders</p> Signup and view all the answers

    Which of the following is associated with PGAD II?

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

    What is the underlying abnormality in PGAD I?

    <p>T cell-mediated immunity</p> Signup and view all the answers

    Which of the following is NOT a feature of PGAD I?

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

    What is the typical complication of PGAD I that affects the stomach?

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

    What is the primary cause of Addison disease?

    <p>Underproduction of cortisol by the adrenal glands</p> Signup and view all the answers

    At what percentage of total adrenocortical tissue dysfunction does the onset of Addison disease typically occur?

    <p>90%</p> Signup and view all the answers

    What is the function of corticotropin-releasing hormone (CRH) in the HPA axis?

    <p>Acting as a chemical messenger between the hypothalamus and the pituitary gland</p> Signup and view all the answers

    Which of the following hormones is responsible for stimulating cortisol release from the adrenal glands?

    <p>Adrenocorticotropic hormone (ACTH)</p> Signup and view all the answers

    What is the role of cortisol in the body's physiological response to stress?

    <p>Contributing to the body's physiological response to stress</p> Signup and view all the answers

    What is the most common and specific antibody associated with autoimmune Addison disease?

    <p>Antibodies to steroid 21-hydroxylase</p> Signup and view all the answers

    What is the consequence of a deficiency of functional suppressor T lymphocytes in autoimmune Addison disease?

    <p>Proliferation of plasma cells that produce immunoglobulins against cells within the adrenal cortex</p> Signup and view all the answers

    What is the significance of detecting antibodies to steroid 21-hydroxylase in patients without symptomatic Addison disease?

    <p>It indicates a high risk of developing adrenal insufficiency</p> Signup and view all the answers

    What percentage of patients with AD experience an addisonian crisis when they first see a health professional?

    <p>25%</p> Signup and view all the answers

    What is the percentage of patients with CPAI who exhibit hyperpigmentation of the skin and mucous membranes?

    <p>90%</p> Signup and view all the answers

    What is the typical duration of time that hyperpigmentation precedes other clinical manifestations of AD?

    <p>Months to years</p> Signup and view all the answers

    What is the normal range of cortisol levels in the morning, when baseline cortisol levels are normally highest each day?

    <p>5-10 µg/dL</p> Signup and view all the answers

    What is the primary test used to diagnose AD, which assesses the functional capacity of the adrenal cortex to synthesize cortisol?

    <p>Rapid ACTH stimulation test</p> Signup and view all the answers

    What is the dose of synthetic ACTH (cosyntropin) used in the rapid ACTH stimulation test?

    <p>0.25 mg</p> Signup and view all the answers

    How many times does a normal adrenal cortex release its basal plasma cortisol output within 15-30 minutes of ACTH treatment?

    <p>Two to five times</p> Signup and view all the answers

    At what time interval after cosyntropin administration are two more blood samples drawn for cortisol assay and aldosterone determination?

    <p>30-60 minutes</p> Signup and view all the answers

    Study Notes

    Addison's Disease

    • Also known as chronic primary adrenocortical insufficiency (CPAI), a potentially life-threatening neuroendocrine or hormonal disorder and chronic metabolic condition.
    • Caused by destruction or dysfunction of adrenal cortical tissue.
    • Characterized by diminished glucocorticoid (cortisol) and, less commonly, mineralocorticoid (aldosterone) and adrenal androgen function.

    History

    • First detailed clinical description by Thomas Addison in 1855.
    • Before 1950, CPAI usually resulted from an infection of the adrenal glands, with tuberculosis (TB) being the leading cause.
    • In developed countries, non-specific destruction of the adrenal glands by cells of the immune system (autoimmune reaction) is the most common cause.

    Causes and Risk Factors

    • Insults to the adrenal glands that cause AD are multiple.
    • 80% of cases are caused by gradual destruction of the outer layer of the adrenal gland (adrenal cortex) by the body's immune system, referred to as autoimmune AD.
    • Other causes include:
      • Tuberculosis (10% of cases in developed countries)
      • Adrenoleukodystrophy (X-linked recessive disorder)
      • Hypogonadism (small gonads resulting in ovarian or testicular failure)
      • Polyglandular autoimmune disease (PGAD)

    Pathophysiology

    • The HPA axis regulates the secretion of cortisol from the adrenal glands in response to stress.
    • Corticotropin-releasing hormone (CRH) stimulates adrenocorticotropic hormone (ACTH) release, which stimulates cortisol release.
    • Addison disease specific antibodies are responsible for the autoimmune destruction of the adrenal cortex.

    Diagnosis

    • Hyperpigmentation of the skin and mucous membranes is a clinical hallmark of AD, present in 90% of patients.
    • Low plasma cortisol (< 3 µg/dL) between 6-8 A.M. strongly suggests AD.
    • Definitive diagnosis rests on the assessment of the functional capacity of the adrenal cortex to synthesize cortisol using the rapid ACTH stimulation test.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    Learn about Addison's disease, a hormonal disorder caused by adrenal cortical tissue dysfunction or destruction, leading to diminished glucocorticoid and mineralocorticoid production.

    More Quizzes Like This

    Adrenal Insufficiency Quiz
    90 questions

    Adrenal Insufficiency Quiz

    BenevolentOnyx avatar
    BenevolentOnyx
    Adrenal Insufficiency: Clinical Manifestations &amp; Management
    10 questions

    Adrenal Insufficiency: Clinical Manifestations &amp; Management

    ShinyIron avatar
    ShinyIron
    Adrenal Insufficiency vs Addison's Disease
    50 questions

    Adrenal Insufficiency vs Addison's Disease

    KnowledgeableClavichord avatar
    KnowledgeableClavichord
    Addison's Disease Overview
    8 questions

    Addison's Disease Overview

    ExcellentDeciduousForest avatar
    ExcellentDeciduousForest
    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser