Endocrinology & Diabetes — Flashcards

Flashcard 411: Chronic _____ is the most common cause of tertiary adrenal insufficiency

Answer: steroid therapy

Flashcard 412: The management of addisonian crisis is with immediate _____ followed by 1L normal saline over 30-60 minutes

Answer: Hydrocortisone 100mg IM/IV

Flashcard 413: Sick day rules for Addison's disease are: _____

Answer: double glucocorticoid dose, keep mineralocorticoid dose the same

Flashcard 414: Management of Addison's disease is with daily glucocorticoid replacement with _____ and mineralocorticoid replacement with fludrocortisone

Answer: hydrocortisone

Flashcard 415: Addison's disease causes a _____ due to deficiency of aldosterone resulting in reduced excretion of H+ in the urine

Answer: metabolic acidosis (normal anion gap)

Flashcard 416: _____ replacement is not required in the management of secondary/tertiary adrenal insufficiency because aldosterone production is maintained by the Renin-Angiotensin System

Answer: Mineralocorticoid

Extra: In secondary/tertiary adrenal insufficiency, the defect is in ACTH production. While cortisol (Glucocorticoid) depends on ACTH, aldosterone (Mineralocorticoid) is primarily regulated by the Renin-Angiotensin-Aldosterone System (RAAS) and potassium levels, which remain intact.

Flashcard 417: Hyperpigmentation in Addison's disease occurs particularly on the _____

Answer: palmar creases

Flashcard 418: Diagnosis of addisonian crisis is based on _____

Answer: clinical suspicion

Flashcard 419: A patient has no increase of serum cortisol 30 minutes after being given Synacthen 250ug IM, what is the most likely diagnosis? _____

Answer: Primary adrenal insufficiency (Addison's disease)

Flashcard 420: The most common infectious cause of Addison's disease is _____

Answer: Tuberculosis