15 results
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis ... ) stimulation test ... High baseline ACTH ... Insufficiency #Differential ... Diagnosis #Algorithm #endocrinology
Adrenal Insufficiency Diagnosis Algorithm
Clinical features: 
 - Weight loss, anorexia, Weakness, fatigue, GI distress
 - Hypotension,
skin (due to high ACTH ... stimulating melanocytes ... with cosyntropin stimulation ... #Cosyntropin #Stimulation ... #StimTest #Endocrinology
Diagnosis Adrenal Insufficiency - Algorithm

Step 1) Screening Test: 6-8AM Cortisol Level
 - Early morning cortisol levels
Diagnosis Adrenal ... Test: Cosyntropin Stimulation ... Step 3) Differentiate ... gland) #Adrenal ... #Stimulation #Endocrinology
Hypercortisolism (Cushing syndrome) - Simplified Differential Diagnosis Algorithm
Exogenous (ACTH-independent)
Endogenous
 • ACTH-dependent:
    - ACTH-secreting
) - Simplified Differential ... : - Adrenal ... hyperplasia - Adrenal ... Cushings #syndrome #Differential ... Diagnosis #Algorithm #endocrinology
Primary Adrenal Insufficiency:
 • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
stimulation test ... production • CRH stimulation ... stimulation test ... stimulation test ... diagnosis #testing #endocrinology
Primary vs Secondary Adrenal Insufficiency - Pathophysiology
Primary AI = adrenal glands themselves are the problem. This
be low, while ACTH ... Low ACTH leads to ... limited adrenal ... stimulation, thus ... Pathophysiology #endocrinology
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH

Early am cortisol < 3
Adrenal Insufficiency ... Axis Response to ACTH ... indicates normal adrenal ... #Stimulation #Test ... #Endocrinology
Adrenal Insufficiency - Differential Diagnosis Workup Algorithm
Primary Adrenal Insufficiency:
 • Autoimmune primary adrenal insufficiency
 • Adrenoleukodystrophy,
Adrenal Insufficiency ... - Differential ... apoplexy • Isolated ACTH-deficiency ... Insufficiency #Differential ... Workup #Algorithm #endocrinology
Adrenal Insufficiency Diagnosis Algorithm
Test 1: Baseline AM Cortisol 
 - Beware of major normal value
 -
Adrenal Insufficiency ... pregnancy) Test 2: ACTH ... Stimulation - ... BCM_InternalMed #Adrenal ... Diagnosis #Algorithm #endocrinology
Causes of Adrenal Insufficiency - Differential Diagnosis Algorithm
ACTH-Dependent (Secondary):
 • Pituitary Dysfunction
 • Hypothalamic Dysfunction
ACTH-Independent (Primary):
Insufficiency - Differential ... Diagnosis Algorithm ACTH-Dependent ... Hypothalamic Dysfunction ACTH-Independent ... Insufficiency #AI #Differential ... Algorithm #Causes #endocrinology