Questions and Answers
What role does cortisol play in the body?
A symptom of adrenal insufficiency can include hyperpigmentation.
True
What can prolonged use of steroid treatment lead to regarding cortisol production?
It can affect the body’s own ability to produce cortisol.
The primary hormone that assists the body in responding to stress is __________.
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Match the causes of adrenal insufficiency with their incidence percentages:
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What effect does steroid treatment for adrenal insufficiency have on adrenal crisis risk?
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Surgery is one of the most common causes of adrenal insufficiency.
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Name one symptom other than hyperpigmentation associated with adrenal insufficiency.
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What is the primary cause of Addison's disease?
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Adrenal insufficiency is a common condition affecting a large population.
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What two essential hormones are produced by the adrenal glands?
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Addison’s disease is also known as primary adrenal __________.
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Match the following conditions with their descriptions:
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Which of the following is NOT a possible trigger of acute exacerbation in adrenal insufficiency?
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The body can produce sufficient cortisol in response to extreme stress levels.
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What is the recommended treatment for hypoglycaemia in a patient with adrenal insufficiency?
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The sudden stop to __________ treatment can trigger an acute exacerbation of adrenal insufficiency.
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Match the following possible triggers of adrenal insufficiency exacerbation with their descriptions:
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What is the recommended oxygen saturation (SP02) level to maintain in a patient experiencing an adrenal crisis?
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100mg Hydrocortisone can be administered by paramedics as a routine practice.
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In cases of adrenal insufficiency, what is the importance of rapid transport to a suitable emergency department?
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Study Notes
Adrenal Insufficiency/Addison’s Disease Overview
- Adrenal insufficiency is a rare, treatable condition impacting cortisol and aldosterone production, leading to potential health crises.
- Addison’s disease is also known as primary adrenal insufficiency, caused by damage to the adrenal cortex.
Hormonal Functions
- Cortisol helps regulate blood pressure, balances insulin effects, assists in stress response, and supports immune function.
- Aldosterone regulates salt levels in the blood, necessary for maintaining fluid balance.
Symptoms and Clinical Signs
- Common symptoms include hyperpigmentation (darkened skin) and vitiligo (skin depigmentation).
- Absence of cortisol during stress can cause acute adrenal crisis, potentially leading to rapid health deterioration.
Incidence and Prevalence
- Autoimmune Addison’s disease affects 1 in 10,000 individuals, with approximately 8,400 diagnosed cases in the UK, primarily in young to middle-aged adults.
Causes of Symptoms
- Frequent triggers for adrenal crisis symptoms include:
- Vomiting (33% incidence)
- Diarrhea (23%)
- Flu-like illness (11%)
- Major infections and surgical stress (6% each)
- Injury or severe pain (4%)
- Psychological stress or anxiety (1%)
Treatment Considerations
- Long-term steroid treatment can suppress the body’s own cortisol production:
- Dosages above 40 mg daily for more than a week can cause lasting effects.
- Requires careful monitoring post-treatment to avoid adrenal crisis.
Managing Addisonian Crisis
- Initial assessment should focus on maintaining ABC (Airway, Breathing, Circulation).
- Ensure SpO2 levels above 94% and establish IV access if necessary.
- Administer 100 mg of Hydrocortisone IV or IM; management of hypoglycemia with IV glucose may be needed.
- Rapid transport to a suitable emergency department is critical.
Important Notes
- Stressors such as infections, hypoglycemia, trauma, surgery, and sudden cessation of steroid therapy can exacerbate adrenal insufficiency.
- Individuals require careful management during acute events to prevent life-threatening outcomes.
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Description
This quiz covers essential information about adrenal insufficiency, specifically Addison's disease. It explores the roles of cortisol and aldosterone in regulating blood pressure, immune response, insulin effects, stress response, and blood salt levels. Test your knowledge on this critical endocrine condition.
