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13 Cards in this Set
- Front
- Back
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What causes adrenal insufficiency? |
Inadequate production of steroid hormones in the adrenal cortex of the adrenal glands |
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What are symptoms of adrenal insufficiency? |
Fatigue, GI upset, anorexia, weight loss, musculoskeletal symptoms, salt cravings and dizziness or passing out (syncope) due to hypotension |
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What is primary adrenal insufficiency? |
Disorders that affect the adrenal cortex e.g. Addison's disease, congenital adrenal hyperplasia) |
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What is secondary adrenal insufficiency? |
Disorders that affect the anterior pituitary gland e.g. pituitary tumor or subarachnoid hemorrhage |
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What is tertiary adrenal insufficiency? |
Disorders that affect the hypothalamus e.g. hypothalamic-pituitary-adrenal axis suppression |
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What are symptoms of adrenal crisis (acute adrenal insufficiency)? |
Severe dehydration, hypotension, hypovolemic shock, altered consciousness, seizures, stroke, cardiac arrest. Can lead to death or permanent disability, if left untreated |
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What is a patient-held Steroid Emergency Card? |
Developed for patients with adrenal insufficiency and steroid dependence who are at risk of adrenal crisis. |
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What is the aim of the Steroid Emergency Card? |
To support healthcare staff with early recognition of patients at risk of adrenal crisis and the emergency treatment of adrenal crisis |
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Which patients are considered steroid dependent? |
Those with Addison's disease, congenital adrenal hyperplasia and HPA damage from tumours or surgery |
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Adrenal insufficiency is treated with [_corticoid] treatment |
Glucocorticoid. E.g. hydrocortisone (20-30mg OD in 2 divided doses - larger dose OM), prednisolone and rarely dexamethasone. Patients with primary adrenal insufficiency usually require mineralocorticoid replacement (with fludrocortisone 50mcg OD), also, due to aldosterone deficiency |
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What is regarded as 'stress'? |
Surgical or invasive treatment |
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How to manage adrenal crisis? |
Inject hydrocortisone into thighs or deltoid muscles. Prompt glucocorticoid replacement with hydrocortisone and rehydration using a crystalloid fluid (e.g. NaCl 0.9%) |
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Diagnosing Addison's Disease |
Adrenocorticotrophic hormone levels (ACTH levels are high in Addison's disease but low in secondary adrenal insufficiency) Plasma (high) renin and (low) aldosterone Thyroid function (to differentiate Graves disease- hyperthyroidism) ACTH stimulation test (250mcg of tetracosactide [synthetic analogue of ACTH] given IM/IV. Cortisol levels checked before and 30 mins after. In normal adrenal reserve, cortisol increases to >500-550 nanmol/L. In adrenal insufficiency, cortisol levels don't increase as adrenal cortex is receiving maximum stimulation from endogenous ACTH |
