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13 Cards in this Set
- Front
- Back
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What is Addison's Disease characterized by? |
Adrenal Insufficiency - lack of hormone production by the adrenal glands resulting from damage to the adrenal cortex |
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What are some signs and symptoms of Addison's Disease? |
muscle weakness, fatigue, weight loss, decreased appetite, hyper pigmentation, joint pain, and depression |
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In Addison's disease, the adrenal gland produces too little _____ and often too little ______. |
cortisol, aldosterone |
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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) |
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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 |
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What was the outcome of the replacement hormones given to the patient by his MD? |
helped with skin pigmentation and irritable attitude |
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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 |
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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) |
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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 |
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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) |
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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 |
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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 |
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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 |
