endocrinology diagnosis differential amenorrhea pediatrics insufficiency hyponatremia acth secondary primary workup evaluation ai testing

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Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH

Early am cortisol < 3

- Evaluation of ... of primary OR secondary ... then go to stim testing ... or secondary AI ... AI - Low = secondary

Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,

Differential Diagnosis ... , hypoglycemia Testing ... - Primary adrenal ... - Secondary adrenal ... #endocrinology

Adrenal Insufficiency - Differential Diagnosis Workup Algorithm
Primary Adrenal Insufficiency:
• Autoimmune primary adrenal insufficiency
• Adrenoleukodystrophy,

Diagnosis Workup ... or tuberculosis Secondary ... apoplexy • Isolated ACTH-deficiency ... Diagnosis #Workup ... #Algorithm #endocrinology

Diagnosis Adrenal Insufficiency - Algorithm

Step 1) Screening Test: 6-8AM Cortisol Level
- Early morning cortisol levels

Insufficiency - ... require Cosyntropin testing ... Step 3) Differentiate ... primary vs secondary ... #Endocrinology

Causes of Adrenal Insufficiency - Differential Diagnosis Algorithm
ACTH-Dependent (Secondary):
• Pituitary Dysfunction
• Hypothalamic Dysfunction
ACTH-Independent (Primary):

- Differential ... (Secondary): • ... (Primary): • Autoimmune ... #AI #Differential ... #Causes #endocrinology

Adrenal Insufficiency - Diagnosis and Management Summary
Primary Adrenal Insufficiency:
Most Common Cause in the US: Autoimmune Adrenalitis
Other

Management Summary Primary ... AI, hyponatremia ... is absent (low ACTH ... #Primary #Secondary ... #Endocrinology

Primary Adrenal Insufficiency:
• ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because

Primary Adrenal ... #Evaluation #laboratory ... #diagnosis #testing ... #endocrinology ... #workup

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