USMLE/COMLEX - Step 2 - Adrenocortical Insufficiency

USMLE/COMLEX - Step 2 - Adrenocortical Insufficiency The pathophysiology of adrenal insufficiency involves a disruption in the production of steroid hormones by the adrenal glands, which autoimmune destruction, infections, cancer, or disruptions in the production of ACTH by the pituitary gland can cause. The resulting hormonal imbalances can lead to a variety of symptoms and complications. Fatigue and weakness Weight loss and decreased appetite Muscle and joint pain Nausea and vomiting Abdominal pain and diarrhea Salt cravings Hypotension Dehydration Hyperpigmentation Hypoglycemia Hyponatremia Hyperkalemia Elevated levels ACTH Low levels of cortisol and aldosterone Serum cortisol, aldosterone, and adrenocorticotropic hormone ACTH stimulation test Insulin-induced hypoglycemia test CT scan MRI Antibody testing The treatment of adrenocortical insufficiency typically involves hormone replacement therapy to replace the deficient cortisol and aldosterone hormones. The treatment approach may vary depending on the type and severity of the condition, but here are some common treatments: 1. Glucocorticoid replacement therapy involves taking oral glucocorticoid medications, such as hydrocortisone or prednisone, to replace the deficient cortisol hormone. The dose is typically adjusted based on the patient's symptoms and response to treatment. 2. Mineralocorticoid replacement therapy involves taking oral mineralocorticoid medications, such as fludrocortisone, to replace the deficient aldosterone hormone. This medication helps regulate salt and fluid balance in the body. 3. Treatment of underlying causes: If the adrenocortical insufficiency is caused by an underlying medical condition, such as an autoimmune disease or infection, treating the underlying cause may help improve hormone production and reduce symptoms. 4. Management of symptoms: Additional treatments may be recommended to manage specific symptoms, such as anti-nausea medication for nausea and vomiting or electrolyte replacement for imbalances. It is important to note that hormone replacement therapy requires careful monitoring and adjustment to ensure the right balance of hormones is maintained