131 results
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis Algorithm ... hormone (ACTH) stimulation ... Baseline plasma ACTH Low ... insufficiency • Low ... Differential #Diagnosis #Algorithm
Diagnosis Adrenal Insufficiency - Algorithm

Step 1) Screening Test: 6-8AM Cortisol Level
 - Early morning cortisol levels
Diagnosis Adrenal ... Insufficiency - Algorithm ... specificity for AI (but low ... - Low ACTH is ... Insufficiency #Algorithm
Hypokalemia - Differential Diagnosis Algorithm

Transcellular Shift:
 • Alkalosis
 • ↑ beta-2 adrenergic simulation 
 • Erythropoiesis
Differential Diagnosis Algorithm ... beta-2 adrenergic simulation ... vomiting) • Low ... Differential #Diagnosis #Algorithm ... #nephrology #low
Primary Adrenal Insufficiency:
 • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
between 8 and 9 AM - Low ... aldosterone - Low ... between 8 and 9 AM - Low ... Plasma ACTH - Low ... endocrinology #workup
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 ... BCM_InternalMed #Adrenal ... Insufficiency #Testing #Algorithm
Adrenal Insufficiency - Differential Diagnosis Workup Algorithm
Primary Adrenal Insufficiency:
 • Autoimmune primary adrenal insufficiency
 • Adrenoleukodystrophy,
Adrenal Insufficiency ... Differential Diagnosis Workup ... Algorithm Primary ... Differential #Diagnosis #Workup ... #Algorithm #endocrinology
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH

Early am cortisol < 3
Adrenal Insufficiency ... Diagnosis Algorithm ... primary AI - Low ... Insufficiency #Diagnosis #Algorithm ... #ACTH #Stimulation
Workup for Hypophosphatemia - Differential Diagnosis Framework
Rule out spurious hypophosphatemia: paraproteinemia, acute leukemia
Measure Urine Fractional Excretion
Workup for Hypophosphatemia ... FEPO4 ≥ 5% - Renal ... • Normal or Low ... - Normal or Low ... Diagnosis #Framework #Workup
Primary vs Secondary Adrenal Insufficiency - Pathophysiology
Primary AI = adrenal glands themselves are the problem. This
aldosterone will be low ... Low ACTH leads to ... limited adrenal ... stimulation, thus ... low cortisol.
Adrenal Insufficiency Diagnosis Algorithm
Clinical features: 
 - Weight loss, anorexia, Weakness, fatigue, GI distress
 - Hypotension,
Diagnosis Algorithm ... findings (see algorithm ... with cosyntropin stimulation ... Insufficiency #Diagnosis #Algorithm ... #Cosyntropin #Stimulation