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diagnosis differential management causes treatment nephrology ddxof workup peds hematology cardiology gastroenterology pulmonary evaluation neurology em pediatrics endocrinology criticalcare dermatology
Adrenal Insufficiency Algorithm - Cosyntropin Stimulation Test T-1m: Baseline cortisol drawn T0: 250 µg cosyntropin given IV T30m: Repeat
Insufficiency Algorithm ... T-1m: Baseline cortisol ... IV T30m: Repeat cortisol ... drawn T60m: Final cortisol ... Insufficiency #Testing #Algorithm
Cushing Syndrome Testing Algorithm INDICATIONS FOR TESTING: • Suspected Cushing syndrome (central obesity, muscle weakness, refractory hypertension) Testing:
Syndrome Testing Algorithm ... Free Urine • Cortisol ... following morning: Cortisol ... , Serum (or Cortisol ... Syndrome #diagnosis #algorithm
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
Insufficiency Diagnosis Algorithm ... ACTH Early am cortisol ... Cosyntropin - Measure cortisol ... injection - If f/u cortisol ... Insufficiency #Diagnosis #Algorithm
Diagnosis Adrenal Insufficiency - Algorithm Step 1) Screening Test: 6-8AM Cortisol Level - Early morning cortisol levels
Insufficiency - Algorithm ... Screening Test: 6-8AM Cortisol ... Early morning cortisol ... - Peak cortisol ... Insufficiency #Algorithm
Adrenal Insufficiency Diagnosis Algorithm Clinical features: - Weight loss, anorexia, Weakness, fatigue, GI distress - Hypotension,
Insufficiency Diagnosis Algorithm ... findings (see algorithm ... : - AM serum cortisol ... unlikely - If serum cortisol ... Insufficiency #Diagnosis #Algorithm
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis Algorithm ... Consider: SIADH, Cortisol ... #differential #algorithm
Evaluation of Secondary Hypertension • Primary aldosteronism - PRA, PAC • Renal artery stenosis - Renal
Late-night salivary cortisol ... 24-h urine free cortisol
Primary Adrenal Insufficiency Addison's Disease - Damage of the adrenal glands with lack of cortisol, androgens and
glands with lack of cortisol ... RTA type IV) Cortisol ... • Myalgia Cortisol ... BP • ↓ Serum cortisol ... potassium, AM cortisol
Adrenal Insufficiency Diagnosis Algorithm Test 1: Baseline AM Cortisol - Beware of major normal value -
Insufficiency Diagnosis Algorithm ... 1: Baseline AM Cortisol ... Insufficiency #Diagnosis #Algorithm
Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis Algorithm ... plasma ACTH Low Cortisol ... Differential #Diagnosis #Algorithm
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