2019 results
Fibrinolysis. 
Fibrinolysis occurs when plasminogen is activated to plasmin under the influence of factors such as
Plasmin then acts ... and urokinase act ... -antiplasmin), act
Hypercortisolism (Cushing syndrome) - Simplified Differential Diagnosis Algorithm
Exogenous (ACTH-independent)
Endogenous
 • ACTH-dependent:
    - ACTH-secreting
Algorithm Exogenous (ACTH-independent ... Endogenous • ACTH-dependent ... : - ACTH-secreting ... Disease) - ACTH-secreting ... in the body • ACTH-independent
Diagnosis Adrenal Insufficiency - Algorithm

Step 1) Screening Test: 6-8AM Cortisol Level
 - Early morning cortisol levels
Cosyntropin is an ACTH ... to a bolus of ACTH ... - Check ACTH ... the ACTH level ... - Low ACTH is
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Adrenocorticotropic hormone (ACTH ... Baseline plasma ACTH ... High baseline ACTH ... normal baseline ACTH
Medical Management of Acute RV Failure
 • Evaluate and Treat Etiology of RV Failure [e.g. Acute
Supportive Measures Act
Primary Adrenal Insufficiency:
 • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
Insufficiency: • ACTH ... test - Synthetic ACTH ... by endogenous ACTH ... Low • Plasma ACTH ... stimulation by ACTH
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH

Early am cortisol < 3
Axis Response to ACTH ... secondary AI Measure ACTH ... Diagnosis #Algorithm #ACTH
Gout Management in CKD
 • Colchicine
 • NSAID
 • Glucocorticoid
 • ACTH
 • Interleukin-1 Inhibitors

#Gout #Management
Glucocorticoid • ACTH
Renin-Angiotensin-Aldosterone System (RAAS) 

The kidneys produce renin in response to low blood pressure or low plasma
Renin acts on angiotensin ... angiotensin-converting enzyme (ACE ... Angiotensin II acts
Asthma Assessment Tools - Is your patients asthma controlled? 
 - Asthma Control Test (ACT)
Control Test (ACT ... The first is the ACT ... Tools #Diagnosis #ACT