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SGPGI Nursing Officer-2022
Medical & Surgical Nursing
Easy

Addison's disease is caused by deficiency of?

Appeared in: SGPGI Nursing Officer-2022

Explanation

  • Addison's disease is defined as primary adrenal insufficiency, meaning the adrenal glands themselves are damaged and cannot produce adequate hormones.
  • The primary hormone that is deficient is cortisol, a glucocorticoid essential for responding to stress, maintaining blood pressure, and regulating metabolism.
  • While aldosterone (a mineralocorticoid) is also often deficient, cortisol deficiency is the hallmark of the disease.
  • The body attempts to compensate for low cortisol by increasing ACTH production from the pituitary, but the damaged adrenal glands cannot respond.

Why Other Options Were Wrong

  • Option A: In Addison's disease (primary adrenal insufficiency), ACTH levels are high, not deficient. The pituitary gland increases ACTH secretion to try and stimulate the failing adrenal glands.
  • Option B: ADH (Antidiuretic Hormone) is related to water balance. Its deficiency causes diabetes insipidus, which presents with polyuria and polydipsia.
  • Option C: LH (Luteinizing Hormone) and FSH (Follicle-Stimulating Hormone) are gonadotropins that regulate reproductive function. Their deficiency leads to hypogonadism and infertility, not Addison's disease.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: Knowing Pathophysiology of Addison's Disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
  • A key nursing priority is monitoring for and managing Addisonian crisis, a life-threatening emergency caused by acute cortisol deficiency. Triggers include infection, trauma, or sudden withdrawal of steroid medication.
  • Patient education is critical. Nurses must teach patients to never abruptly stop taking their steroid medication, to increase their dose during times of illness or stress (stress dosing), and to wear a medical alert bracelet.
  • What if? If a patient with known Addison's disease presents with fever, vomiting, and confusion, the nurse must suspect an impending Addisonian crisis and prepare for immediate IV hydrocortisone administration and fluid resuscitation, as per protocol, before waiting for lab results.
How to Approach the Question
  • First, identify the core concept of the question, which is 'Addison's disease'.
  • Recall the definition: Addison's disease is primary adrenal insufficiency.
  • Analyze the pathophysiology: In primary insufficiency, the problem is with the adrenal gland itself. It fails to produce its hormones, primarily cortisol.
  • Evaluate each option based on this understanding. A deficiency of cortisol directly matches the definition of the disease.
  • Eliminate the other options by recalling their functions: ACTH deficiency causes secondary insufficiency, ADH deficiency causes diabetes insipidus, and LH/FSH deficiency affects reproduction.
Concept Tested & Keywords
  • Concept Tested: Pathophysiology of Addison's Disease
  • Stem keywords: Addison's disease, deficiency
  • Lead-in keywords: caused by

Question ID

QI6ye9PfgYKVLmuZPLAz4F

Reference Book

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 546-548

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 7502-7504

E6 Medicine Harrison 22e Part 2 p. 971-973

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