Definition
- Q. What is Addison’s disease?
- Q. What do you mean by adrenal insufficiency?
- Q. What is secondary adrenocortical insufficiency?
Epidemiology
Etiology and Pathophysiology
- Q. What are the causes of Addison’s disease?
- Q. What is the commonest cause of Addison’s disease?
- Q. What is the next common cause of Addison’s disease?
- Q. What diseases are associated with Addison’s disease?
- Q. What is the most common cause of adrenal insufficiency? h81
Clinical manifestations
- Q. What are the presentations of Addison’s disease?
- Q. What are the common features of chronic presentation?
- Q. What is the sites of pigmentation in Addison’s disease?
- Q. What is the cause of pigmentation in Addison’s disease?
- Q. What is the differential diagnosis of skin pigmentation?
- Q. What is the differential diagnosis of buccal pigmentation?
- Q. Why vitiligo occurs in Addison’s disease?
- Q. Which clinical feature of Addison’s disease is unique to female and why?
- Q. Why it is not affected in males?
- Q. Which clinical feature of Addison’s disease is unique to male and why?
- Q. Why dose hypotension occure in Addison’s disease?
- Q. Why dose postural hypotension occure in Addison’s disease?
Examinations
- Q. How can you differentiate primary and secondary adrenocortical insufficiency?
Investigations
- Q. How will you investigate this patient?
- Q. How to perform synacthen test?
- Q. What is the finding of chest X-ray in Addison’s disease?
- Q. What autoantibodies are present in autoimmune adrenalitis (Addison’s disease)?
- Q. Which test would you do for adrenal insufficiency?
- Q. Suppose the patient needs steroid for life saving before cortisol assay, which steroid would you prescribe?
Diagnosis
- Q. What are the diagnostic criteria of Addison’s disease?
- Q. What are the differential diagnosis?
Treatment
- Q. How would you treat Addison’s disease?
- Q. What advices would you give to patients on glucocorticoid replacement therapy?
- Q. What drug is avoided in acute abdominal pain in Addison’s disease?
Complications
- Addisonian crisis
- Q. A patient with bronchial asthma was under good control with medication. He went to see his daughter far away from his house but forgot to bring his medicines. Without medication he was free from breathless but in the next morning he developed nausea, vomiting, and collapsed. What is your diagnosis? h78 (Adrenal crisis.)
- Q. Suppose this patient suddenly develops vomiting and collapse, what may be the cause?
- Q. What history would you take?
- Q. What is Addisonian crisis?
- Q. What are the causes of Addisonian crisis?
- Q. What is the commonest cause of Addisonian crisis?
- Q. How would you manage adrenal crisis?
- Q. Why is mineralocorticoid (fludrocortisone) not given in Addisonian crisis?
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