Endo: Addison's Disease: Free MSRA Podcast

🎧MSRA Podcast:Addison’s Disease – The Adrenal Breakdown You Need to Know🧠 One of the most high-yield endocrinology topics for your MSRA. In this episode, we break Addison’sDisease down to its essentials — with memory aids, clinical pearls, andexam-focused takeaways to make it stick. 🧠Key Learning Points📌Definition• Addison’s = Primary adrenal insufficiency• Adrenal cortexfails → low cortisol + often low aldosterone🧠Primary =Pigmentation + Problem in the adrenal 📌CausesAutoimmune destruction (~80–85% in UK)Infections (e.g. TB, HIV, CMV)Metastases (e.g. from lung cancer)Genetic (e.g. CAH in children, adrenoleukodystrophy)Hemorrhage (e.g. Waterhouse-Friderichsen)🧠 Think "AIM High" = Autoimmune, Infection, Metastases, Hemorrhage 📌Pathophysiology• In primary, ↓ cortisol + ↓ aldosterone• In secondary, ↓ cortisol only (aldosterone spared)🧠 Aldosterone = RAAS-driven, not ACTH-dependent• Hyperpigmentation= ↑ ACTH → ↑ MSH🧠Primary =Pigmentation Present 📌Clinical Features• Fatigue, weightloss, muscle weakness• Postural hypotension, salt craving, nausea, vomiting• Hyperpigmentation (palmar creases, buccalmucosa)• Electrolyte issues: ↓ Na+, ↑ K+, ↓ glucose🧠Salt + Sugar + Skin= Addison’s 📌Adrenal Crisis🚨 Medical emergency• Triggers: illness,surgery, steroid withdrawal• Signs: shock, confusion,severe hypotension, vomiting, collapse• Immediatetreatment:→ IV hydrocortisone 100 mg stat→ IV 0.9% saline (+ dextrose if hypoglycaemic)🧠Don’t delay – treatfirst, confirm later 📌Diagnosis• Morning cortisol (8–9 am)500 = unlikely Addison’s<100 = highly suggestive100–500 = needs short Synacthen test• ACTH test = Low cortisol + ↑ ACTH = Primary Addison’s• Electrolytes: ↓ Na+, ↑ K+, ↓ glucose • Anti-21 hydroxylase antibodies = autoimmune confirmation🧠 Synacthen = Synthetic ACTH 📌Management• Hydrocortisone (divided doses to mimiccircadian rhythm)• Fludrocortisone (if aldosterone low – inprimary only)• Sick Day Rules: Double/triple hydrocortisoneduring illness• Emergency IM hydrocortisone kit – life-saving• Carry steroid card + medicalID🧠Hydro = Hormone,Fludro = Fluid balance 📌Long-term Care &Monitoring• Annualendocrinology review• Monitor: symptoms,BP, electrolytes, renin levels• Educate on crisisprevention, injection training, travel prep🧠Education =Prevention 📌Complications• Adrenal crisis (life-threatening if untreated)• Reduced quality of life (fatigue, low libido)• Osteoporosis (possible with long-term steroiduse)• Associatedautoimmune diseases: T1DM, Hashimoto’s, Perniciousanaemia, Vitiligo 📚Addison’s DiseaseMSRA Resources📝 Revision Notes:https://www.passthemsra.com/topic/addisons-disease-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/addisons-disease-flashcards/❓ Q&A Accordions:https://www.passthemsra.com/topic/addisons-disease-accordion-qa-notes/🔥 Rapid Quiz:https://www.passthemsra.com/topic/addisons-disease-rapid-quiz/ Hashtags#MSRA#AddisonsDisease #AdrenalCrisis #EndocrinologyMSRA #MSRAFlashcards #MSRAQuiz#ACTHtest #SynacthenTest #PrimaryAdrenalInsufficiency #SickDayRules#MSRADeepDive #MSRAPodcast #MSRAHighYield