IGNOU PB. Bsc. Nsg. Entrance-2025
Medical & Surgical Nursing
Easy
In Addison's disease there is insufficient secretion of:
Appeared in: IGNOU PB. Bsc. Nsg. Entrance-2025
Explanation
- Addison's disease is defined as primary adrenal insufficiency, a condition where the adrenal glands are damaged and cannot produce sufficient hormones.
- The primary hormone deficient in Addison's disease is cortisol, a glucocorticoid essential for managing stress, blood sugar, and metabolism.
- The adrenal glands may also fail to produce enough aldosterone, a mineralocorticoid that regulates sodium and potassium balance.
- This deficiency originates from the adrenal gland itself, not from the pituitary or thyroid glands.
Why Other Options Were Wrong
- Option A: Thyroid hormone is produced by the thyroid gland. Its deficiency causes hypothyroidism, which has distinct symptoms like fatigue, weight gain, and cold intolerance.
- Option B: Parathyroid hormone (PTH) is secreted by the parathyroid glands to regulate calcium and phosphate levels. Its deficiency leads to hypoparathyroidism, characterized by hypocalcemia and tetany.
- Option D: While a deficiency in a pituitary hormone (specifically ACTH) does cause adrenal insufficiency, it is termed 'secondary adrenal insufficiency'. Addison's disease is, by definition, 'primary adrenal insufficiency', meaning the defect is within the adrenal gland itself.
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 responsibility is to recognize the signs of an 'Addisonian crisis' (acute adrenal insufficiency), a life-threatening emergency characterized by severe hypotension, hypoglycemia, and hyperkalemia, often triggered by stress or illness.
- Patient education is critical. Nurses must teach patients with Addison's disease about lifelong hormone replacement therapy, the importance of not missing doses, and the need to increase their steroid dose during times of illness, injury, or surgery ('stress dosing').
- What if? If a patient had low cortisol but also low ACTH levels, the diagnosis would shift from primary (Addison's) to secondary adrenal insufficiency. This indicates the problem originates in the pituitary gland, not the adrenal gland, and the treatment approach might need to investigate a pituitary cause.
How to Approach the Question
- First, identify the key term in the question stem: 'Addison's disease'.
- This is a factual recall question. Access your knowledge about the definition of this specific endocrine disorder.
- Recall that Addison's disease is also called primary adrenal insufficiency.
- The term 'adrenal insufficiency' directly points to a problem with the adrenal gland's hormone production.
- Evaluate the options to identify the primary hormone produced by the adrenal cortex. Cortisol is the main glucocorticoid from the adrenal cortex.
- Eliminate the other options by linking them to their respective glands: Thyroid hormone (thyroid), Parathyroid hormone (parathyroid), and Pituitary hormone (pituitary).
Concept Tested & Keywords
- Concept Tested: Pathophysiology of Addison's disease
- Stem keywords: Addison's disease, insufficient secretion
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Negative lead-in flag: false
Question ID
QiRAqywyFAfl7i-e-prUd4
Reference Book
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 Davidson Principles Practice 24e p. 693-695
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1264-1266
Practise the full IGNOU PB. Bsc. Nsg. Entrance-2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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