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Cushing Syndrome Testing Algorithm INDICATIONS FOR TESTING: • Suspected Cushing syndrome (central obesity, muscle weakness, refractory hypertension) Testing:
Syndrome Testing Algorithm ... Free Urine • Cortisol ... Urine Free by LC-MS ... /MS) • Adrenocorticotropic ... Syndrome #diagnosis #algorithm
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
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
Adrenal Insufficiency Diagnosis Algorithm Clinical features: - Weight loss, anorexia, Weakness, fatigue, GI distress - Hypotension,
Insufficiency Diagnosis Algorithm ... Clinical features ... findings (see algorithm ... : - AM serum cortisol ... unlikely - If serum cortisol
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
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis Algorithm ... Consider: SIADH, Cortisol ... #differential #algorithm
Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis Algorithm ... Clinical suspicion ... plasma ACTH Low Cortisol ... Differential #Diagnosis #Algorithm
Cortical Desmoid - MSK Radiology Imaging Findings: • Circumscribed, small cortically based Tl -hypointense and T 2-hyperintense
Cortical Desmoid ... - MSK Radiology ... #Desmoid #clinical ... #mri #clinical ... Radiology #diagnosis #msk
Joint Pain - Differential Diagnosis Articular: Infectious, Degenerative, Inflammatory Non-articular: Localized, General #Joint #Pain #Differential #Diagnosis #MSK #algorithm
Differential #Diagnosis #MSK ... #algorithm
Adrenal Insufficiency Diagnosis Algorithm Test 1: Baseline AM Cortisol - Beware of major normal value -
Insufficiency Diagnosis Algorithm ... 1: Baseline AM Cortisol ... Insufficiency #Diagnosis #Algorithm
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