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Questions and Answers
Addison's disease is also referred to as secondary adrenal insufficiency.
Addison's disease is also referred to as secondary adrenal insufficiency.
False (B)
Adrenal insufficiency affects 1 in 10,000 individuals in the UK.
Adrenal insufficiency affects 1 in 10,000 individuals in the UK.
True (A)
Cortisol and aldosterone are produced by the adrenal glands, which are located beneath the kidneys.
Cortisol and aldosterone are produced by the adrenal glands, which are located beneath the kidneys.
False (B)
Cortisol helps regulate blood pressure and assists the body in responding to stress.
Cortisol helps regulate blood pressure and assists the body in responding to stress.
Adrenal insufficiency is classified as a common but manageable condition.
Adrenal insufficiency is classified as a common but manageable condition.
In adrenal insufficiency, hyperpigmentation is a more common symptom than severe fatigue.
In adrenal insufficiency, hyperpigmentation is a more common symptom than severe fatigue.
An acute crisis in adrenal insufficiency can lead to rapid deterioration of health and potentially death.
An acute crisis in adrenal insufficiency can lead to rapid deterioration of health and potentially death.
The incidence of symptoms such as vomiting and diarrhea in adrenal insufficiency is less than 50%.
The incidence of symptoms such as vomiting and diarrhea in adrenal insufficiency is less than 50%.
Steroid treatment can disrupt the body's ability to produce cortisol for up to a year after stopping.
Steroid treatment can disrupt the body's ability to produce cortisol for up to a year after stopping.
Surgery and major infections both contribute equally to the incidence of adrenal insufficiency symptoms at 6%.
Surgery and major infections both contribute equally to the incidence of adrenal insufficiency symptoms at 6%.
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Study Notes
Overview of Adrenal Insufficiency/Addison’s Disease
- Adrenal insufficiency, including Addison’s Disease, is characterized by inadequate production of cortisol and aldosterone.
- Cortisol and aldosterone are essential for regulating blood pressure, immune function, insulin balance, stress response, and blood salt levels.
Symptoms and Physical Manifestations
- Hyperpigmentation and vitiligo are common symptoms associated with Addison’s Disease.
Causes and Incidence
- Most common causes triggering adrenal crises include:
- Vomiting (33%)
- Diarrhea (23%)
- Flu-like illness (11%)
- Major infection (6%)
- Surgery (6%)
- Blackouts/loss of consciousness (6%)
- Severe pain/injury (4%)
- Shock (4%)
- 1 in 10,000 individuals is affected by autoimmune Addison's disease in the UK, with around 8,400 diagnosed cases primarily in young and middle-aged adults.
Treatment Considerations
- Prolonged use of steroid treatments can suppress the body’s ability to produce cortisol, leading to a risk of adrenal crisis even after treatment has stopped.
Types of Adrenal Insufficiency
- Primary adrenal insufficiency (Addison’s Disease) results from damage to the adrenal cortex.
- Secondary adrenal insufficiency occurs due to the pituitary gland underfunctioning or prolonged steroid use.
Triggers for Acute Exacerbation
- Potential triggers for an adrenal crisis include:
- Infections
- Hypoglycemia
- Stress
- Trauma or surgery
- Burns
- Pregnancy
- Medical emergencies (e.g., myocardial infarction)
- Abrupt steroid withdrawal
Crisis Management
- In an adrenal crisis, the patient may deteriorate rapidly, necessitating immediate medical intervention:
- Assess and manage airway, breathing, and circulation (ABC).
- Maintain oxygen saturation above 94%.
- Establish intravenous access as needed and administer 100mg Hydrocortisone IV or IM.
- Manage hypoglycemia with IV glucose if required.
- Monitor ECG and ensure rapid transport to an appropriate emergency department.
Conclusion
- Adrenal insufficiency is a rare yet serious condition requiring timely diagnosis, treatment, and understanding of management protocols during crises.
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