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Addison’s Disease (Examination (Main Signs (Medic alert bracelet,…
Addison’s Disease
Examination
Main Signs
-
Hyperpigmentation
- Palmar creases
- Scars
- Buccal mucosa
-
Extras
Signs of AI disease
- DM
- Vitiligo
- Hyperthyroidism
-
Viva
Hx
Symptoms
- Wt. loss + anorexia
- Lethargy, depression
- Dizziness, faints
Cause
- Other AI disease: DM, vitiligo
- TB
Ix
Bloods
- U+E: ↓Na, ↑K
- ↓ glucose
- Abs: 21-hydroxylase (+ve in 80% c¯ AI disease)
Confirm Dx
- 8am cortisol: low
- 8am ACTH: high
- SynACTHen test: no ↑ in cortisol
-
-
Mx
-
Chronic
-
Pt. education and advice
Don’t stop steroids suddenly
↑ dose during illness / stress
Wear medic alert bracelet
Carry steroid card