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diagnosis insufficiency differential stimulation video acth adrenalmass causes cosyntropin evaluation injury neurology physicalexam syndrome acromegaly acute aki artery benign blood
Cushing Syndrome Testing Algorithm INDICATIONS FOR TESTING: • Suspected Cushing syndrome (central obesity, muscle weakness, refractory hypertension) Testing:
Algorithm INDICATIONS ... dexamethasone suppression test ... Hormone • MRI of adrenal ... #endocrinology ... #Adrenal #Hyperfunction
Adrenal Insufficiency Algorithm - Cosyntropin Stimulation Test T-1m: Baseline cortisol drawn T0: 250 µg cosyntropin given IV T30m: Repeat
Adrenal Insufficiency ... Algorithm - Cosyntropin ... Stimulation Test ... Insufficiency #Testing ... #Stimulation #endocrinology
Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis Algorithm ... Clinical suspicion ... , hypoglycemia Testing ... ACTH) stimulation test ... #endocrinology
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
Diagnosis Algorithm ... then go to stim testing ... Standard Stim test ... #Stimulation #Test ... #Endocrinology
Adrenal Insufficiency Diagnosis Algorithm Clinical features: - Weight loss, anorexia, Weakness, fatigue, GI distress - Hypotension,
Diagnosis Algorithm ... Clinical features ... cosyntropin stimulation test ... interact with stim test ... Stimulation #StimTest #Endocrinology
Primary Adrenal Insufficiency: • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
ACTH stimulation test ... autoantibody tests ... laboratory #diagnosis #testing ... #endocrinology ... #workup
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup ... and Diagnosis Algorithm ... mimics, repeat testing ... for renal biopsy ... #Workup #urology
Diagnosis Adrenal Insufficiency - Algorithm Step 1) Screening Test: 6-8AM Cortisol Level - Early morning cortisol levels
Insufficiency - Algorithm ... Step 1) Screening Test ... require Cosyntropin testing ... Insufficiency #Algorithm ... #Stimulation #Endocrinology
Hypoglycemia - Differential Diagnosis Algorithm Fasting Hypoglycemia: • Excess Insulin • Medications (e.g. Insulin Secretagogues, ß-Adrenergic Antagonists,
Differential Diagnosis Algorithm ... Other Causes: • Critical ... Hypopituitarism • Adrenal ... Differential #Diagnosis #Algorithm ... #endocrinology
Benign Adrenal Mass - Differential Diagnosis Algorithm Hyperplasia - Often Bilateral • Congenital Adrenal Hyperplasia • ACTH
Benign Adrenal Mass ... • Congenital Adrenal ... High Plasma E2 +Clinical ... Dexamethasone Suppression Test ... #Endocrinology
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