Don't Fight the Hypo-
Primary or Secondary?
100
Salt craving in adrenal insufficiency can be attributed to this hormonal change.
What is hypoaldosteronism?
100
Adrenalectomy causes this variety of adrenal insufficiency.
What is primary adrenal insufficiency?
200
Fatigue in an adrenal tumor patient could be explained by this hormonal change.
What is hypocortisolism?
200
These cosyntropin stimulation test results indicate this variety of adrenal insufficiency.
What is primary adrenal insufficiency?
300
A 36 yo woman with known autoimmune adrenalitis presents to your office for evaluation of loss of axillary hair, worried that this represents a new disease process. You reassure her that it can be explained by this hormonal change associated with her known adrenal insufficiency.
What is hypoandrogenism?
300
Long-term cortisol therapy causes this variety of adrenal insufficiency.
What is secondary adrenal insufficiency?
(Prolonged iatrogenic suppression of the hypothalamic-pituitary-adrenal axis due to long-term cortisol therapy → ↓ CRH/ACTH release (negative feedback) → ↓ endogenous cortisol)
400
Hyponatremia secondary to adrenal insufficiency could be explained by either of these two hormonal changes.
What are hypoaldosteronism or hypocortisolism?
Hypoaldosteronism:
Aldosterone increases renal Na+ reabsorption
Hypocortisolism:
ADH is a hormone involved in water reabsorption in the kidney. Glucocorticoids inhibit ADH secretion and thereby prevent excessive water retention. With adrenal insufficiency, ADH secretion is disinhibited causing increased reabsorption of free water with subsequent dilution hyponatremia.
400
Tuberculosis causes this variety of adrenal insufficiency.
What is primary adrenal insufficiency?
(Tuberculous adrenal insufficiency is caused by destruction of the adrenal glands by caseous necrosis.)
500
A 30 year old man, s/p adrenalectomy 1 week ago, presents to the emergency department following a syncopal episode. He reports that he was lying on the couch watching television, and that the last thing he remembers is rapidly jumping up to answer the doorbell. You attribute the event to this hormonal change.
What is hypocortisolism?
(This is orthostatic hypotension.
Glucocorticoids play an important role in catecholamine‑induced vasoconstriction.)
500
A female aged 13 years and 3 months visited the pediatric endocrinology clinic due to short stature. The patient was 133 cm (−3.4 standard deviation scores) in height with a growth velocity of less than 4 cm/year.
To evaluate the possibility of pituitary hormone deficiencies, a combined pituitary stimulation test was performed; decreased cortisol secretion was observed.
The patient most likely has this form of adrenal insufficiency.
What is secondary adrenal insufficiency.
"This case presented with non-functioning pituitary adenoma associated with GH and ACTH deficiency, which is in accordance with a previous study demonstrating that non-functioning pituitary adenomas may present with GH deficiency (up to 75%), LH/FSH deficiency (~40%), or ACTH and TSH deficiency (~25%)."