Case Study Addison's Disease
1. Discuss diagnostic findings of Addison’s disease.
Addison’s disease, otherwise known as primary adrenal insufficiency, appear after the adrenal cortex is destroyed. Due to this, hormones such as cortisol and aldosterone decrease or stop being produced by the defective adrenal gland. Those hormones start a chain reactive within the body that cause other lab values such as glucose to be out of the normal range. Additionally the rate at which the kidneys filter slows and waste products can build up.
According to the Mayo Clinic (Nov. 2015) the most common diagnostic tests used to determine if a patient has Addison’s Disease are a blood test, a ACTH stimulation test, CT imaging and if they are suspecting an adrenal insufficiency but are unsure if they are dealing with primary or secondary insufficiency, they may order an Insulin-inducted hypoglycemia test. …show more content…
The most common test is the ACTH (Adrenocorticotropic Hormone) stimulation test.
According to Timby & Smith, (201) the patient is administered a dose of synthetic cosyntropin via an intramuscular injection and then tested for cortisol response. The Mayo clinic further elaborates that this is done because the ACTH stimulates the adrenal gland to produce cortisol and the lack of hormone released indicates an adrenal malfunction and subsequent insufficiency. Blood tests are done to test levels of necessary minerals like sodium and potassium and to check on the white blood count as to rule out autoimmune adrenal insufficiency. CT scans of the abdomen allow the provider to visualize the adrenal glands that rest on the superior aspect of the kidneys and see either enlargement or shrinkage that may be present. On positive test results of adrenal gland insufficiency, you’ll be able to see that, “Sodium and fasting blood glucose levels are low, and potassium, calcium and blood urea nitrogen levels are increased” (Timby & Smith, 2014, page
848)
2. Discuss urinary 17-Hydroxycorticosteroids. Urinary 17-hydroxycorticosteroids are found during a urine screening for adrenal insufficiency. Lippincott Advisor for Education-Diagnostic Tests describes how 17-hydroxycorticosteriods and remaining hormone metabolites are found in the urine and are used to control gluconeogenesis within the body. This diagnostic test works accurately because of the metabolites dispelled in the urine, 80% or more are cortisol metabolites. If those are not present, it indicates the adrenal glands are not properly functioning.
Addison’s disease, otherwise known as primary adrenal insufficiency, appear after the adrenal cortex is destroyed. Due to this, hormones such as cortisol and aldosterone decrease or stop being produced by the defective adrenal gland. Those hormones start a chain reactive within the body that cause other lab values such as glucose to be out of the normal range. Additionally the rate at which the kidneys filter slows and waste products can build up.
According to the Mayo Clinic (Nov. 2015) the most common diagnostic tests used to determine if a patient has Addison’s Disease are a blood test, a ACTH stimulation test, CT imaging and if they are suspecting an adrenal insufficiency but are unsure if they are dealing with primary or secondary insufficiency, they may order an Insulin-inducted hypoglycemia test. …show more content…
The most common test is the ACTH (Adrenocorticotropic Hormone) stimulation test.
According to Timby & Smith, (201) the patient is administered a dose of synthetic cosyntropin via an intramuscular injection and then tested for cortisol response. The Mayo clinic further elaborates that this is done because the ACTH stimulates the adrenal gland to produce cortisol and the lack of hormone released indicates an adrenal malfunction and subsequent insufficiency. Blood tests are done to test levels of necessary minerals like sodium and potassium and to check on the white blood count as to rule out autoimmune adrenal insufficiency. CT scans of the abdomen allow the provider to visualize the adrenal glands that rest on the superior aspect of the kidneys and see either enlargement or shrinkage that may be present. On positive test results of adrenal gland insufficiency, you’ll be able to see that, “Sodium and fasting blood glucose levels are low, and potassium, calcium and blood urea nitrogen levels are increased” (Timby & Smith, 2014, page
848)
2. Discuss urinary 17-Hydroxycorticosteroids. Urinary 17-hydroxycorticosteroids are found during a urine screening for adrenal insufficiency. Lippincott Advisor for Education-Diagnostic Tests describes how 17-hydroxycorticosteriods and remaining hormone metabolites are found in the urine and are used to control gluconeogenesis within the body. This diagnostic test works accurately because of the metabolites dispelled in the urine, 80% or more are cortisol metabolites. If those are not present, it indicates the adrenal glands are not properly functioning.