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diagnosis endocrinology differential stimulation cosyntropin evaluation hyponatremia hypotonic laboratory management nephrology physiologic primary secondary sodium stimtest table testing workup
Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Adrenal Insufficiency ... Weakness, fatigue, nausea ... , hypotension, hyponatremia ... ) stimulation test ... • Low or normal
Primary Adrenal Insufficiency: • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
Insufficiency: ... aldosterone - Low in cases ... insufficiency. ... adrenal insufficiency ... aldosterone - Often normal
Adrenal Insufficiency Diagnosis Algorithm Clinical features: - Weight loss, anorexia, Weakness, fatigue, GI distress - Hypotension,
Adrenal Insufficiency ... skin (due to high ACTH ... hypoglycemia, Hyponatremia ... cosyntropin stimulation test ... interact with stim test
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
Adrenal Insufficiency ... Diagnosis Algorithm ... unclear (often the case ... Standard Stim test ... this indicates normal
Adrenal Insufficiency Diagnosis Algorithm Test 1: Baseline AM Cortisol - Beware of major normal value -
Adrenal Insufficiency ... Diagnosis Algorithm ... Test 1: Baseline ... Beware of major normal ... 2: ACTH Stimulation
Adrenal Insufficiency - Diagnosis and Management Summary Primary Adrenal Insufficiency: Most Common Cause in the US: Autoimmune Adrenalitis Other
Adrenal Insufficiency ... secondary AI, hyponatremia ... Adrenal Insufficiency ... A STIM test can ... ACTH STIM TEST:
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... of hypotonic hyponatremia ... remember than the normal ... volume-based algorithm ... Insufficiency,
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