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diagnosis algorithm insufficiency stimulation differential cosyntropin management primary secondary signs symptoms syndrome workup addisons adrenalmass benign causes cushing cushings disease
Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
, hypoglycemia Testing ... ) stimulation test ... Baseline plasma ACTH ... High baseline ACTH ... Diagnosis #Algorithm #endocrinology
Primary Adrenal Insufficiency: • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
stimulation test ... autoantibody tests ... stimulation test ... laboratory #diagnosis #testing ... #endocrinology
Diagnosis Adrenal Insufficiency - Algorithm Step 1) Screening Test: 6-8AM Cortisol Level - Early morning cortisol levels
Step 1) Screening Test ... require Cosyntropin testing ... ) Confirmation Test ... This test determines ... #Stimulation #Endocrinology
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
Adrenal Insufficiency ... then go to stim testing ... Standard Stim test ... #Stimulation #Test ... #Endocrinology
Primary Adrenal Insufficiency Addison's Disease - Damage of the adrenal glands with lack of cortisol, androgens and
clue • Blood tests ... stimulation test ... test is not affected ... test is affected ... addisons #disease #endocrinology
Adrenal Insufficiency Diagnosis Algorithm Test 1: Baseline AM Cortisol - Beware of major normal value -
Adrenal Insufficiency ... Diagnosis Algorithm Test ... OCPs, pregnancy) Test ... 2: ACTH Stimulation ... Diagnosis #Algorithm #endocrinology
Adrenal Insufficiency Algorithm - Cosyntropin Stimulation Test T-1m: Baseline cortisol drawn T0: 250 µg cosyntropin given IV T30m: Repeat
Adrenal Insufficiency ... Cosyntropin Stimulation Test ... BCM_InternalMed #Adrenal ... Insufficiency #Testing ... #Stimulation #endocrinology
Adrenal Insufficiency Diagnosis Algorithm Clinical features: - Weight loss, anorexia, Weakness, fatigue, GI distress - Hypotension,
Adrenal Insufficiency ... skin (due to high ACTH ... cosyntropin stimulation test ... interact with stim test ... Stimulation #StimTest #Endocrinology
Acromegaly Testing Algorithm INDICATIONS FOR TESTING: • Adults – enlarged facial or acral features, abnormal musculoskeletal growth
Acromegaly Testing ... INDICATIONS FOR TESTING ... linear growth Tests ... ARUPConsult @ARUPLabs #Acromegaly ... #diagnosis #endocrinology
Benign Adrenal Mass - Differential Diagnosis Algorithm Hyperplasia - Often Bilateral • Congenital Adrenal Hyperplasia • ACTH
Benign Adrenal Mass ... Hyperplasia • ACTH ... Dependent • ACTH ... Dexamethasone Suppression Test ... Diagnosis #Algorithm #Endocrinology
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