34 results
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis ... Baseline plasma ACTH ... High baseline ACTH ... #Differential # ... Diagnosis #Algorithm #endocrinology
Adrenal Insufficiency - Differential Diagnosis Workup Algorithm
Primary Adrenal Insufficiency:
 • Autoimmune primary adrenal insufficiency
 • Adrenoleukodystrophy,
Adrenal Insufficiency ... - Differential ... apoplexy • Isolated ACTH-deficiency ... #Differential # ... Workup #Algorithm #endocrinology
Causes of Adrenal Insufficiency - Differential Diagnosis Algorithm
ACTH-Dependent (Secondary):
 • Pituitary Dysfunction
 • Hypothalamic Dysfunction
ACTH-Independent (Primary):
Causes of Adrenal Insufficiency ... - Differential ... Diagnosis Algorithm ACTH-Dependent ... #AI #Differential ... Algorithm #Causes #endocrinology
Hypercortisolism (Cushing syndrome) - Simplified Differential Diagnosis Algorithm
Exogenous (ACTH-independent)
Endogenous
 • ACTH-dependent:
    - ACTH-secreting
) - Simplified Differential ... Endogenous • ACTH-dependent ... : - ACTH-secreting ... Cushings #syndrome #Differential ... Diagnosis #Algorithm #endocrinology
Diagnosis Adrenal Insufficiency - Algorithm

Step 1) Screening Test: 6-8AM Cortisol Level
 - Early morning cortisol levels
Diagnosis Adrenal Insufficiency ... - Check ACTH ... Step 3) Differentiate ... ) #Adrenal #Insufficiency ... #Stimulation #Endocrinology
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH

Early am cortisol < 3
Adrenal Insufficiency ... Axis Response to ACTH ... secondary AI Measure ACTH ... AI #Adrenal #Insufficiency ... Stimulation #Test #Endocrinology
Primary vs Secondary Adrenal Insufficiency - Pathophysiology
Primary AI = adrenal glands themselves are the problem. This
Secondary Adrenal Insufficiency ... be low, while ACTH ... Low ACTH leads to ... Secondary #Adrenal #Insufficiency ... Pathophysiology #endocrinology
Primary Adrenal Insufficiency:
 • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
Primary Adrenal Insufficiency ... primary adrenal insufficiency ... Secondary Adrenal Insufficiency ... secondary adrenal insufficiency ... diagnosis #testing #endocrinology
Adrenal Insufficiency Diagnosis Algorithm
Test 1: Baseline AM Cortisol 
 - Beware of major normal value
 -
Adrenal Insufficiency ... pregnancy) Test 2: ACTH ... BCM_InternalMed #Adrenal #Insufficiency ... Diagnosis #Algorithm #endocrinology
Adrenal Insufficiency Diagnosis Algorithm
Clinical features: 
 - Weight loss, anorexia, Weakness, fatigue, GI distress
 - Hypotension,
Adrenal Insufficiency ... skin (due to high ACTH ... PRIMARY adrenal insufficiency ... > 18, adrenal insufficiency ... Stimulation #StimTest #Endocrinology