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4. Addison’s Disease | Internal Medicine Must-Know for NEET PG, USMLE, FMGE & MBBS 💯

Addison’s Disease, also known as Primary Adrenal Insufficiency, is a serious endocrine disorder caused by the destruction or dysfunction of the adrenal cortex, leading to deficiency of cortisol, aldosterone, and androgens 🌅🧬. It is most commonly due to autoimmune adrenalitis in developed countries, while tuberculosis remains a major cause in developing nations 🌍. This condition affects both glucocorticoid and mineralocorticoid production, making it life-threatening if untreated.

Key Clinical Features:
• Hyperpigmentation of skin and mucosa due to high ACTH levels (cross-reacts with melanocyte-stimulating hormone) 🟤
• Fatigue, muscle weakness, and weight loss 🪫
• Hypotension, especially postural (due to aldosterone deficiency) 💉
• Salt craving and dehydration 🌊
• Hypoglycemia and hyponatremia, along with hyperkalemia ⚠️
• GI symptoms: nausea, vomiting, abdominal pain, diarrhea

Diagnosis:
• Early morning serum cortisol – low
• ACTH stimulation test (Short Synacthen Test) – confirms adrenal insufficiency
• Serum ACTH – elevated in primary, low in secondary
• Electrolytes – low sodium, high potassium
• Autoantibodies (21-hydroxylase Abs) – in autoimmune cases
• CT abdomen – to detect adrenal calcification (TB) or atrophy

Treatment:
• Hydrocortisone – to replace cortisol
• Fludrocortisone – to replace aldosterone
• Stress-dose steroids during illness, surgery, trauma
• Patient education on adrenal crisis prevention and emergency steroid use 🩺

This video gives you an in-depth yet simplified explanation of Addison’s disease using animated concepts, clinical cases, and mnemonics—perfect for NEET PG, USMLE Step 2 CK, FMGE, and MBBS preparation 🎯📚.

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