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13 Cards in this Set

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  • Back

What is Addison's Disease characterized by?

Adrenal Insufficiency - lack of hormone production by the adrenal glands resulting from damage to the adrenal cortex

What are some signs and symptoms of Addison's Disease?

muscle weakness, fatigue, weight loss, decreased appetite, hyper pigmentation, joint pain, and depression

In Addison's disease, the adrenal gland produces too little _____ and often too little ______.

cortisol, aldosterone

Addison's Disease (chronic hypoadrenalism) leads to low cortisol, low sex hormone and hypoaldosteronism. What effect do each of these have on the patient?

Low cortisol - hypoglycemia, hypercalcaemia & anemia, high ACTH / MSH, pigmentation

low sex hormone - loss of body & pubic hair, loss of libido/amenorrhea, muscle wasting and thin limbs

hypoaldosteronism- low serum [Na+], high serum [K+], dehydration (low ECV incl. TBV), postural hypotension, weight loss, high plasma (renin)

Therapeutic suggestions under PT: patient was told he needed replacement hormones, such as ______ or ______, to make up for the ones that his adrenal glands can no longer produce

hydrocortisone or prednisone

What was the outcome of the replacement hormones given to the patient by his MD?

helped with skin pigmentation and irritable attitude

What is the main treatment for addison's disease? What potential side effects of these medications have?

glucocorticoid replacement treatments taken 2-3 times per day by the patient

potential side effects of osteoporosis, obesity, and cardiovascular morbidity

What is the difference between primary adrenal insufficiency and secondary adrenal insufficiency?

primary adrenal insufficiency caused by primary adrenal gland disorder = addison's disease

secondary adrenal insufficiency is caused by a deficiency of ACTH (reduced ACTH from the AP produces low levels of cortisol from AC)

How can injury to the hypothalamus lead to adrenal insufficiency (addison's disease)?

injury to the hypothalamus can lead to reduced CRH, which leads to ACTH deficiency and then adrenal insufficiency

A common cause of primary adrenal insufficiency is a rare autoimmune disease that causes the immune system to attack the adrenal cortical cells. What is this called? What is it associated with?

Autoimmune poly-endocrine syndrome (APS) or multiple endocrine deficiency syndrome

APS Type I - childhood (<21 yr) and associated with Addison's disease, diminished parathyroid function (low Ca2+ affects nerves and muscles), delayed or slow sexual development, diabetes (DM type 1), celiac's disease (eating gluten leads to immune reaction in GI)

What are some other causes of Addison's Disease?

- Amyloidosis - protein build up in organs (very rare)

- bleeding into the adrenal glands

- cancer that spreads to the adrenal glands

- infections (bacterial, fungal, tuberculosis) of the adrenal glands

- surgical removal of the adrenal glands

What is Adrenal Crisis or Addisonian Crisis? What are the symptoms?

insufficient levels of cortisol that can be fatal - dehydration and/or severe vomiting and diarrhea, stabbing pain in abdomen, low back, or legs, low blood pressure (shock), low blood sugar, loss of consciousness

What is needed for a patient who experiences Addisonian Crisis?

needs IV of isotonic NaCl to restore volume deficit and correct hypotension; provide hydrocortisone in soluble form to maintain plasma cortisol levels (improvement in 4-6 hr)

as patient weaned off hydrocortisone, mineralocorticoid replacement should be instituted (in doses equivalent to the daily adrenal gland output of 0.05-0.20 mg every 24 hr)

Na+ intake