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diagnosis nephrology differential endocrinology insufficiency management acth causes hypokalemia potassium workup epilepticus evaluation gitelman hyperkalemia hypernatremia hypotonic k laboratory pathophysiology
Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
, hypotension, hyponatremia ... , hypoglycemia Testing ... hormone (ACTH) stimulation ... test AND • Baseline ... plasma ACTH Low
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... High Uric Acid → renal ... salt wasting By ... #nephrology #sodium
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Hypothyroidism, Adrenal ... Cerebral salt wasting ... Primary polydipsia, Low ... #sodium #nephrology
Primary Adrenal Insufficiency: • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
between 8 and 9 AM - Low ... aldosterone - Low ... cases in which injury ... Plasma ACTH - Low ... laboratory #diagnosis #testing
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Based Approach to Hyponatremia ... Cerebral salt wasting ... Hypothyroidism, Low ... #algorithm #diagnosis ... #sodium #low #nephrology
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... Sodium loss (diuretics ... can be high or low ... Cerebral Salt Wasting ... #nephrology
Diagnosis Adrenal Insufficiency - Algorithm Step 1) Screening Test: 6-8AM Cortisol Level - Early morning cortisol levels
Insufficiency - Algorithm ... specificity for AI (but low ... require Cosyntropin testing ... : Cosyntropin Stimulation ... - Low ACTH is
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 ... primary AI - Low ... #ACTH #Stimulation
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... • Euvolemic (Low ... , Ingestion Renal ... Diagnosis #Workup #Algorithm ... #nephrology #sodium
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
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