TRC: Secondary adrenal insufficiency

Secondary adrenal insufficiency

Secondary adrenal insufficiency describes the situation in which a shortage of ACTH impairs normal function of the cells in the zona fasciculata. The other cells of the cortex, in the zona reticularis and zona glomerulosa, are not affected by this disorder. The hormones produced in these zones (aldosterone in the zona glomerulosa, sex steroids in the zona reticularis) are only controlled in a limited extent by ACTH.

As a result of deficient ACTH levels, cortisol levels drop. This is accompanied by symptoms like gastrointestinal complaints, hypotension, low blood glucose levels and weakness. Administration of glucocorticoids relieves the symptoms.

I. Mineralocorticoids are required in the treatment of secondary adrenal insufficiency.

II. Adrenal insufficiency can occur when treatment with exogenous steroids is stopped.

Extra info: In secondary adrenal insufficiency, i.e. ACTH deficiency, only the glucocorticoid levels are decreased. Therefore, administration of mineralocorticoids is not recommended. Long-term use of exogenous steroids results in a strong negative feedback on the hypothalamic-pituitary-adrenal axis. Thus, when the use of exogenous steroids is stopped, the ACTH levels may be so depressed, that they hardly can achieve concentration required for stimulation of the adrenal gland.

Option explanation:

I is true, II is false

I is true, II is true

I is false, II is false

I is false, II is true

Reduced fluid losses in urine due to the retention of sodium ions and water is a result of the action of

Extra info: Aldosterone is responsible for the retention of sodium ions from the tubular fluid.

Option explanation:

ADH

calcitonin

aldosterone

cortisol