USMLE/COMLEX - Step 2 - Addison's Disease

USMLE/COMLEX - Step 2 - Addison's Disease Addison's disease is primarily caused by autoimmune destruction of the adrenal glands but can also result from infections, tumors, or medication use. The condition disrupts the normal function of the adrenal glands and the HPA axis, leading to insufficient production of cortisol and aldosterone. The HPA axis compensates by increasing ACTH secretion, but the damaged adrenal glands cannot respond appropriately. Fatigue and weakness Weight loss and decreased appetite Low blood pressure Salt cravings Muscle or joint pain Darkening of the skin Nausea, vomiting, and diarrhea Irritability or depression Addisonian crisis (severe vomiting and diarrhea, low blood pressure, confusion) in severe cases Hypotension Hyponatremia Hyperkalemia Hypoglycemia Eosinophilia Anemia Hyperpigmentation Gastrointestinal symptoms Psychological symptoms Blood tests with elected levels of cortisol, aldosterone, and ACTH ACTH stimulation test Insulin-induced hypoglycemia test CT or MRI scans Antibody tests Treating Addison's disease involves lifelong replacement therapy with glucocorticoids and mineralocorticoids, hormones produced by the adrenal glands. The specific medications and dosages prescribed will depend on the severity of the disease and each patient's needs. Some common treatment options for Addison's disease: 1. Glucocorticoid replacement therapy: This involves taking a synthetic form of cortisol, such as hydrocortisone, prednisone, or dexamethasone, to replace the deficient cortisol levels in the body. 2. Mineralocorticoid replacement therapy involves taking a synthetic form of aldosterone, such as fludrocortisone, to replace the deficient aldosterone levels in the body. 3. Salt supplements: Some patients with Addison's disease may need extra salt supplements to help maintain healthy sodium levels. 4. Management of stress: Patients with Addison's disease may need to take extra medication doses during stress or illness to prevent adrenal crisis. 5. Education and support: Patients with Addison's disease may benefit from education and support to help them manage their condition effectively and prevent complications.