Failure to Diagnose & Delay in Treatment of Addison's Disease

Evaluate breaches in the standard of care when determining if there was a Failure to Diagnose & Delay in Treatment of Addison's Disease

Answer the following questions to find out if the standard of care was followed for your case.

  • With which of the following symptoms did the patient present? (Choose all that apply)
    Chronic fatigue
    Weakness
    Weight loss
    Loss of appetite
    None of the above
    Answer unknown
    Why is this important?
    Addison’s disease is a rare but potentially fatal disorder of the adrenal glands. Its manifestations are often confused with many common disorders. Addison’s disease is a potentially lethal condition if left untreated, yet its diagnosis is often missed or delayed.
    (2010) 123 AMJLME 5 409-413

  • Insufficiency did the present? Why is this important?
    Answer this question
    It is very important on the part of the clinician to identify the symptoms and signs of acute adrenal insufficiency since these conditions can be life threatening.
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  • Was fluid replacement and corticosteroid therapy initiated? Why is this important?
    Answer this question
    The clinician must immediately proceed with stabilization of vital signs, achieve fluid balance and begin steroid replacement therapy in a patient presenting with Addisonian crisis.
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  • Was the steroid dose adjusted accordingly? Why is this important?
    Answer this question
    Coexisting disease such as tuberculosis or neoplasms must be effectively treated or controlled.
    (2010) 123 AMJLME 5 409-413

  • Was patient education provided? Why is this important?
    Answer this question
    The clinician must provide necessary instructions to the patient/care taker regarding the further management and precautions to be taken after starting medication.
    (2010) 123 AMJLME 5 409-413

  • Were follow-up evaluations advised? Why is this important?
    Answer this question
    A patient diagnosed with Addison’s disease and undergoing therapy needs to be followed-up with on a routine basis for better prognosis and to avoid influence of adverse reactions.
    (2010) 123 AMJLME 5 409-413

  • Which of the following risk factors were elicited from the patient? (Choose all that apply) Why is this important?
    Answer this question
    A medical history revealing the contributory conditions to Addison’s disease must be elicited to aid in a correct diagnosis of the condition.
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  • Was a thorough medical history obtained? Why is this important?
    Answer this question
    There is a familial recessive trend of Addison’s disease in some cases. Autoimmune diseases such as thyroid disease, parathyroid disease, or diabetes mellitus in the family history may increase the risk of Addison’s disease.
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  • Was a physical examination performed? Why is this important?
    Answer this question
    A physical examination, including checking for hyper-pigmentation, vitiligo, orthostatic hypertension, generalized weakness and loss of axillary hair in female needs to be performed.
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  • Were laboratory investigations performed? Why is this important?
    Answer this question
    Lab investigations need to be conducted for the diagnosis and further management of Addison’s disease.
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  • Were abdominal imaging studies performed? Why is this important?
    Answer this question
    Abdominal radiography is used for the diagnosis of Addison’s disease.
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  • Was the patient referred to an endocrinologist? Why is this important?
    Answer this question
    The clinician must refer the patient to an endocrinologist after the initial diagnosis.
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  • Which of the following treatment options were initiated? (Choose all that apply) Why is this important?
    Answer this question
    An adequate daily supplementation of glucocorticoids and mineralocorticoids to mimic normal physiology needs to be administered. This must aim to maintain normal blood pressure, blood glucose and fluid volume, and instill a sense of well-being in the patient.
    (2010) 123 AMJLME 5 409-413