22 results
Evaluating a Patient with Presumed Cushing Syndrome

#Cushings #Syndrome #Disease #Algorithm #Workup #Dexamethasone #Suppression #Test #diagnosis
Evaluating a Patient ... with Presumed Cushing ... Syndrome #Disease #Algorithm ... #Suppression #Test ... #diagnosis
Hypercortisolism (Cushing syndrome) - Simplified Differential Diagnosis Algorithm
Exogenous (ACTH-independent)
Endogenous
 • ACTH-dependent:
    - ACTH-secreting
Simplified Differential Diagnosis ... Algorithm Exogenous ... hyperplasia - Adrenal ... #Differential #Diagnosis ... #Algorithm #endocrinology
Adrenal Incidentalomas: Hormone Evaluation
 • Zona Glomerulosa: Primary Hyperaldosteronism?
    - Aldosterone and renin
Adrenal Incidentalomas ... Zona Fasciculata: Cushing ... dexamethasone test ... #Diagnosis #workup ... #endocrinology
Cushing Syndrome Testing Algorithm
INDICATIONS FOR TESTING:
 • Suspected Cushing syndrome (central obesity, muscle weakness, refractory hypertension)
Testing:
Testing Algorithm ... dexamethasone suppression test ... Hormone • MRI of adrenal ... #Syndrome #diagnosis ... #algorithm #endocrinology
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 ... level drawn BCM IM ... #Stimulation #endocrinology
Adrenal Insufficiency Diagnosis Algorithm
Test 1: Baseline AM Cortisol 
 - Beware of major normal value
 -
Adrenal Insufficiency ... Diagnosis Algorithm ... Test 1: Baseline ... response BCM IM ... #Algorithm #endocrinology
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH

Early am cortisol < 3
Diagnosis Algorithm ... - Evaluation of ... Standard Stim test ... #Algorithm #ACTH ... #Endocrinology
Hirsutism - Differential Diagnosis Algorithm
RAPID ONSET
Medications
 • Steroids
 • Danazol
 • Progestin Containing Contraceptives
Increased Serum Testosterone
- Differential Diagnosis ... Algorithm RAPID ... Serum DHEAS • Adrenal ... Ovarian Syndrome • Cushing's ... #Algorithm #endocrinology
Hirsutism & Virilization - Differential Diagnosis Algorithm
ADRENAL EXCESS
Ovarian
 • Polycystic Ovarian Syndrome
 • Hyperthecosis
 • Tumor
Adrenal
- Differential Diagnosis ... Algorithm ADRENAL ... Hyperplasia • Cushing's ... #Differential #Diagnosis ... #Algorithm #endocrinology
Adrenal Insufficiency Diagnosis Algorithm
Clinical features: 
 - Weight loss, anorexia, Weakness, fatigue, GI distress
 - Hypotension,
Diagnosis Algorithm ... findings (see algorithm ... cosyntropin stimulation test ... interact with stim test ... Stimulation #StimTest #Endocrinology