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diagnosis differential nephrology endocrinology insufficiency potassium acth evaluation hyperkalemia hypokalemia hypotonic k laboratory low management physiologic sodium table treatment workup
Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Weakness, fatigue, nausea ... , hypotension, hyponatremia ... , hypoglycemia Testing ... hormone (ACTH) stimulation ... test AND • Baseline
Causes of Hyponatremia - Differential Diagnosis Algorithm Hypovolemia, UNa > 20: • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... tubal acidosis ... Cerebral salt wasting ... #Causes #nephrology
Primary Adrenal Insufficiency: • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
Insufficiency: • ACTH stimulation ... aldosterone - Low in cases ... in which injury ... production • CRH stimulation ... laboratory #diagnosis #testing
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
Diagnosis Algorithm ... unclear (often the case ... then go to stim testing ... Standard Stim test ... #ACTH #Stimulation
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... Hypothyroidism, Adrenal ... Cerebral Salt Wasting ... table #sodium #nephrology
Hypokalemia Evaluation Algorithm Before evaluating hypokalemia, life threatening complications such as arrhythmias and paralysis should be looked
Hypokalemia Evaluation Algorithm ... from other causes ... causes • Laxative ... syndrome, Congenital adrenal ... - Metabolic acidosis
Hyperkalemia - Diagnosis and Management - GrepMed Handbook S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Weakness, cramping, nausea ... , rhabdo/crush injury ... Cortisol+ACTH stim test ... only if no clear cause ... Treatment #potassium #nephrology
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