Endocrinology & Diabetes — Flashcards

Flashcard 401: Patients with secondary/tertiary adrenal insufficiency _____ experience an increase in serum cortisol 30 minutes after being given 250ug Synacthen IM.

Answer: will not

Extra: In secondary or tertiary adrenal insufficiency, the lack of chronic ACTH stimulation leads to adrenal cortical atrophy. Consequently, the glands cannot respond acutely to exogenous ACTH (Synacthen). Note: In very early/acute secondary AI (e.g., within days of a pituitary insult), the adrenals might still respond, but for exam purposes, they are expected to fail the stim test.

Flashcard 402: Patient's with Addison's disease are at increased risk of other _____ diseases so consider screening

Answer: autoimmune

Flashcard 403: Fludrocortisone is a _____corticoid

Answer: mineralo

Flashcard 404: What complication of bacterial septicemia can cause addisonian crises? _____

Answer: Waterhouse-Friderichsen syndrome

Flashcard 405: Addison's disease _____ rules should be implemented during periods of physical stress such as surgery, trauma, acute illness

Answer: sick day

Flashcard 406: Sudden discontinuation of glucocorticoids can cause _____

Answer: addisonian crises

Flashcard 407: The most common congenital cause of Addison's disease is _____

Answer: congenital adrenal hyperplasia (CAH)

Flashcard 408: Sick day rules for Addison's disease are: _____

Answer: double glucocorticoid dose, keep mineralocorticoid dose the same

Flashcard 409: Hyperpigmentation in Addison's disease occurs particularly on the _____

Answer: palmar creases

Flashcard 410: A diagnosis of _____ should be suspected in patients presenting with multiple endocrine deficiencies, such as adrenal insufficiency combined with hypoparathyroidism or thyroid disease.

Answer: Autoimmune Polyglandular Syndrome (APS)

Extra: • APS Type 1: Adrenal insufficiency, Hypoparathyroidism, and Chronic Mucocutaneous Candidiasis. • APS Type 2: Adrenal insufficiency, Autoimmune Thyroid Disease, and Type 1 Diabetes Mellitus.