12 results
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
, hypotension, hyponatremia ... , hypoglycemia Testing ... ) stimulation test ... Low Cortisol Response ... insufficiency • Low
Adrenal Insufficiency Diagnosis Algorithm
Clinical features: 
 - Weight loss, anorexia, Weakness, fatigue, GI distress
 - Hypotension,
Diagnosis Algorithm ... skin (due to high ACTH ... hypoglycemia, Hyponatremia ... test: Steroids ... interact with stim test
Diagnosis Adrenal Insufficiency - Algorithm

Step 1) Screening Test: 6-8AM Cortisol Level
 - Early morning cortisol levels
Insufficiency - Algorithm ... (but low sensitivity ... require Cosyntropin testing ... : Cosyntropin Stimulation ... - Low ACTH is
Primary Adrenal Insufficiency:
 • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
stimulation test ... cases in which injury ... stimulation test ... stimulation test ... laboratory #diagnosis #testing
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 ... - Low = secondary ... #ACTH #Stimulation
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... irrigants Hypotonic Hyponatremia ... Hypothyroidism, Adrenal ... Primary polydipsia, Low
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... case of hypotonic hyponatremia ... normal volume-based algorithm ... Cerebral Salt Wasting ... Physiologic #Hypotonic #Hyponatremia
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... High Uric Acid → renal ... salt wasting By ... Rachel Stern MD #Hyponatremia ... #nephrology #sodium
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Cerebral salt wasting ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology
Adrenal Insufficiency - Diagnosis and Management Summary
Primary Adrenal Insufficiency:
Most Common Cause in the US: Autoimmune Adrenalitis
Other
, hyponatremia may ... Hyperpigmentation is absent (low ... ACTH). ... A STIM test can ... ACTH STIM TEST: