Secondary adrenal insufficiency electrolyte pattern: which is preserved?

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Prepare for the Mark Klimek Electrolytes and Endocrine Test. Utilize flashcards, multiple choice questions, and detailed explanations for each query to enhance your understanding. Ace your exam!

Multiple Choice

Secondary adrenal insufficiency electrolyte pattern: which is preserved?

Explanation:
Aldosterone is preserved because its release is driven mainly by the renin-angiotensin system rather than ACTH. In secondary adrenal insufficiency, ACTH is low and cortisol falls, but the zona glomerulosa still responds to angiotensin II, so aldosterone production and its effects on sodium and potassium balance remain intact. That’s why you don’t get the hyperkalemia or significant hyponatremia that reflect aldosterone loss seen in primary adrenal failure. Hyponatremia can occur due to cortisol deficiency causing increased ADH and fluid retention, and hypoglycemia can occur from cortisol deficiency, but the aldosterone axis stays functioning.

Aldosterone is preserved because its release is driven mainly by the renin-angiotensin system rather than ACTH. In secondary adrenal insufficiency, ACTH is low and cortisol falls, but the zona glomerulosa still responds to angiotensin II, so aldosterone production and its effects on sodium and potassium balance remain intact. That’s why you don’t get the hyperkalemia or significant hyponatremia that reflect aldosterone loss seen in primary adrenal failure. Hyponatremia can occur due to cortisol deficiency causing increased ADH and fluid retention, and hypoglycemia can occur from cortisol deficiency, but the aldosterone axis stays functioning.

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