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Hypoadrenalism Gus Brooks Ali Chakera Angus Jones
Scope of today's talk ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary hypoadrenalism Addison’s disease
A typical case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
VE, 26♀ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
VE, 26♀ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Issues highlighted by case ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical questions ,[object Object],[object Object],[object Object],[object Object],[object Object]
What is primary hypoadrenalism?
A bit of history ,[object Object],[object Object],[object Object],[object Object],[object Object]
1 º  hypoadrenalism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Are there any cardinal symptoms and signs of primary hypoadrenalism?
A typical case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Suspicion Symptoms  Signs  Laboratory results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Suspicion Symptoms  Signs  Laboratory results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pitfalls in diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Other associations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How do we diagnose Addison’s disease?
VE, 26 ♀ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Short-synacthen test (SST) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Underlying cause ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Addison’s disease ,[object Object],[object Object],[object Object],Infective ,[object Object],[object Object],[object Object],Bilateral adrenalectomy Haemorrhage / infarction Infiltration ,[object Object],[object Object],Drugs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of primary hypoadrenalism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of hypoadrenalism
Management of hypoadrenalism +ve +ve -ve -ve
How do we treat primary hypoadrenalism?
VE, 26♀ ,[object Object],[object Object],[object Object]
Glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Glucocorticoid ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The problem patient… ,[object Object]
[object Object],[object Object],[object Object],[object Object],Mineralocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What about the androgens? ,[object Object],[object Object],[object Object],[object Object],[object Object]
How should we monitor patients with primary hypoadrenalism?
VE, 26♀ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Patient Education ,[object Object],[object Object],[object Object],[object Object],[object Object]
Routine review ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other tests ,[object Object],[object Object],[object Object],[object Object],[object Object]
How do you manage primary hypogonadism in an unwell patient
VE, 26♀ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recognising  a crisis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Managing a crisis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of physiologically unwell patients ,[object Object],[object Object],[object Object]
 
Exeter surgical guidelines
Other situations
Pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Exercise ,[object Object],[object Object]
 
Questions?
[object Object]

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Hypoadrenalism

Notas do Editor

  1. “ It will hardly be disputed that at the present moment, the functions of the supra renal capsules, and the influence they exercise in the general economy, are almost or altogether unknown. The large supply of blood which they receive from three separate sources; their numerous nerves, derived immediately from the semilunar ganglia and solar plexus; their early development in the fœtus; their unimpaired integrity to the latest period of life; and their peculiar gland-like structure; all point to the performance of some important office: nevertheless, beyond an ill-defined impression, found on a consideration of their ultimate organization, that, in common with the spleen, thymus and thyroid body, they in some way or other minister to the elaboration of the blood, I am not aware that any modern authority has ventured to assign to them any special function of influence whatever.”