4916 results
Primary Adrenal Insufficiency
Addison's Disease - Damage of the adrenal glands with lack of cortisol, androgens and
aldosterone Causes ... : Most Common Causes ... Tuberculosis: can cause ... AM cortisol and ACTH ... AI present - ACTH
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
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Weakness, fatigue, nausea ... Adrenocorticotropic hormone (ACTH ... Baseline plasma ACTH ... High baseline ACTH ... normal baseline ACTH
Causes of Adrenal Insufficiency - Differential Diagnosis Algorithm
ACTH-Dependent (Secondary):
 • Pituitary Dysfunction
 • Hypothalamic Dysfunction
ACTH-Independent (Primary):
Causes of Adrenal ... Diagnosis Algorithm ACTH-Dependent ... Hypothalamic Dysfunction ACTH-Independent ... Diagnosis #Algorithm #Causes
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 ... looking at the ACTH ... - Low ACTH is
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH

Early am cortisol < 3
Axis Response to ACTH ... unclear (often the case ... secondary AI Measure ACTH ... Diagnosis #Algorithm #ACTH
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 ... aldosterone - Low in cases
Adrenal Insufficiency - Diagnosis and Management Summary
Primary Adrenal Insufficiency:
Most Common Cause in the US: Autoimmune Adrenalitis
Other
: Most Common Cause ... Adrenalitis Other causes ... is absent (low ACTH ... Causes of Secondary ... ACTH STIM TEST:
Cushing's Syndrome - Hypercortisolism - Diagnosis and Clinical Features
1) Skin
 • Thin, easily bruisable skin with
, oral cavity) Caused ... by excessive ACTH ... same precursor as ACTH ... polyuria in the case ... hypertension (90% of cases
Fibrinolysis. 
Fibrinolysis occurs when plasminogen is activated to plasmin under the influence of factors such as
Plasmin then acts ... and urokinase act ... -antiplasmin), act