Addison's disease is associated with - - RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

Addison's disease is defined as primary chronic adrenocortical insufficiency.
It is caused by the progressive autoimmune or infectious destruction of the adrenal cortex.
This destruction leads to a deficiency in the production of essential hormones like cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid).
The loss of negative feedback from cortisol results in increased pituitary ACTH secretion, causing the characteristic hyperpigmentation.

Option B: The thyroid gland produces thyroid hormones (T3 and T4). Its dysfunction leads to hypothyroidism or hyperthyroidism.
Option C: The anterior pituitary produces ACTH. Its failure leads to secondary adrenal insufficiency, which is distinct from primary Addison's disease. A key differentiator is that secondary insufficiency has low ACTH and therefore no hyperpigmentation.
Option D: The posterior pituitary stores and releases antidiuretic hormone (ADH). Its dysfunction causes conditions related to water balance, such as Diabetes Insipidus or SIADH.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology and etiology of Addison's disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must educate patients on the critical need for lifelong hormone replacement (hydrocortisone, fludrocortisone) and the dangers of abruptly stopping medication.
A key nursing priority is teaching patients to recognize the signs of an impending Addisonian crisis (e.g., vomiting, abdominal pain, hypotension) and the need for an emergency injection of corticosteroids.
Patient education should emphasize the 'sick day rules': doubling the daily glucocorticoid dose during febrile illness or stress to prevent a crisis.

How to Approach the Question

First, identify the core medical condition in the question: 'Addison's disease'.
Recall the fundamental definition of this condition. Addison's disease is also known as primary adrenal insufficiency.
The name 'adrenal insufficiency' directly points to the adrenal gland as the affected organ.
Analyze the specific part of the adrenal gland involved. The disease process involves the destruction of the outer layer, the adrenal cortex.
Scan the options to find the one that matches this knowledge: 'Adrenal cortex'.
Briefly rule out the other endocrine glands. The thyroid is for metabolism, and the pituitary is the 'master gland' which, if faulty, causes secondary (not primary) adrenal issues.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1122-1124

E6 Medicine Davidson Principles Practice 24e p. 693-695

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1261-1263