Overview of Adrenal Insufficiency

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Questions and Answers

Which of the following is NOT a possible trigger for acute exacerbation of adrenal insufficiency?

Medical emergencies such as MI

Chronic fatigue (correct)

Surgery

Traumatic injuries

What vital sign should be maintained above 94% in a patient with adrenal insufficiency?

SP02 (correct)

Heart Rate

Temperature

Blood Pressure

What is the recommended dosage of hydrocortisone for acute management of adrenal insufficiency?

100mg IV or IM (correct)

150mg IV

50mg IV

200mg IM

In the event of adrenal insufficiency, what should be prioritized alongside managing ABC symptoms?

Establishing IV access if indicated (A) Signup and view all the answers

What condition may occur when the body cannot adequately increase cortisol production?

Crisis state (B) Signup and view all the answers

Which option is part of the acute management protocol for adrenal insufficiency?

Manage hypoglycaemia with IV glucose where required (D) Signup and view all the answers

Which of the following is NOT a sign of acute adrenal insufficiency?

Sudden increase in appetite (D) Signup and view all the answers

What should be done if a patient suddenly stops steroid treatment?

Monitor for potential adrenal crisis (D) Signup and view all the answers

What is the primary cause of Addison's disease?

Damage to the adrenal cortex (B) Signup and view all the answers

What hormone is NOT produced sufficiently in Addison's disease?

Adrenaline (A), Insulin (D) Signup and view all the answers

What is the prevalence of autoimmune Addison's disease in the UK?

1 in 10,000 (C) Signup and view all the answers

What can cause secondary adrenal insufficiency?

De-functioning pituitary gland (B) Signup and view all the answers

Which of the following statements about adrenal insufficiency is TRUE?

It can lead to rapid deterioration in health during an acute crisis. (B) Signup and view all the answers

What role do cortisol and aldosterone play in the body?

Help regulate blood pressure (A) Signup and view all the answers

Which of the following is NOT a symptom of adrenal insufficiency?

Increased appetite (C) Signup and view all the answers

How long can the effects of steroid treatment on the body’s cortisol production last after discontinuation?

Up to a year (D) Signup and view all the answers

Which of the following conditions has the highest incidence percentage as a cause of adrenal insufficiency?

Vomiting (D) Signup and view all the answers

What is a consequence of taking high doses of steroids for extended periods?

Reduced cortisol production capability (A) Signup and view all the answers

What physical skin change is commonly associated with adrenal insufficiency?

Vitiligo (C) Signup and view all the answers

Which of the following conditions has the lowest incidence as a cause of adrenal insufficiency?

Anxiety (A) Signup and view all the answers

Which hormone is primarily responsible for balancing the effects of insulin?

Cortisol (B) Signup and view all the answers

Study Notes

Adrenal Insufficiency/Addison’s Disease Overview

Adrenal insufficiency, particularly Addison’s disease, involves the adrenal glands producing insufficient cortisol and aldosterone.
Cortisol and aldosterone are critical for blood pressure regulation, immune function, insulin balance, stress response, and blood salt regulation.

Symptoms and Physical Manifestations

Common symptoms include hyperpigmentation and vitiligo.
Hyperpigmentation can occur on skin areas exposed to sunlight and other inflammatory lesions.

Causes and Incidence

Incidence correlates with various causes:
- Vomiting (33%), Diarrhea (23%), Flu-like illness (11%), Major infections (6%), Surgery (6%).
- Other causes include blackout/LOC (6%), severe pain (4%), shock (4%), and severe fatigue/inadequate medication (2%).
- Unknown causes and psychological distress each represent 1%.

Steroid Treatment Effects

Long-term steroid treatment of 40 mg for over a week may suppress the body's cortisol production for up to a year post-discontinuation.
Risks include increased likelihood of developing adrenal crises.

Prevalence

Autoimmune Addison’s affects approximately 1 in 10,000 individuals in the UK with about 8,400 diagnosed cases.
Typically affects young to middle-aged populations.

Types of Adrenal Insufficiency

Primary (Addison’s disease) involves adrenal cortex damage.
Secondary adrenal insufficiency is due to pituitary gland dysfunction affecting cortisol signaling.
Long-term steroid use can also lead to secondary adrenal insufficiency.

Triggers of Acute Exacerbation

Acute exacerbation triggers may include:
- Infections, hypoglycemia, stress, traumatic injuries, surgery, burns, pregnancy, significant medical emergencies, and sudden discontinuation of steroid treatment.

Management During Crisis

Essential to assess and manage airway, breathing, and circulation (ABC).
Maintain oxygen saturation (SP02) above 94%.
Establish IV access for emergency treatment.
Administer 100 mg of Hydrocortisone IV or IM in severe cases.
Manage hypoglycemia through IV glucose administration.
Immediate ECG monitoring and rapid transport to the nearest emergency department are critical.

Patient Management Objectives

Understand and describe characteristics of adrenal insufficiency.
Effectively manage patients experiencing Addisonian crises to prevent rapid health deterioration.

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Description

This quiz covers the essential aspects of adrenal insufficiency, particularly focusing on Addison's disease. Explore its symptoms, causes, and the significance of cortisol and aldosterone in bodily functions. Test your understanding of treatment effects and the disease's physical manifestations.