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Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis ... Algorithm Clinical ... ACTH) stimulation test ... insufficiency • Low ... #endocrinology
Benign Adrenal Mass - Differential Diagnosis Algorithm Hyperplasia - Often Bilateral • Congenital Adrenal Hyperplasia • ACTH
Benign Adrenal Mass ... - Differential ... High DHEAS • Low ... Dexamethasone Suppression Test ... #Endocrinology
Diagnosis Adrenal Insufficiency - Algorithm Step 1) Screening Test: 6-8AM Cortisol Level - Early morning cortisol levels
Insufficiency - Algorithm ... specificity for AI (but low ... Step 3) Differentiate ... - Low ACTH is ... #Stimulation #Endocrinology
Hirsutism & Virilization - Differential Diagnosis Algorithm ADRENAL EXCESS Ovarian • Polycystic Ovarian Syndrome • Hyperthecosis • Tumor Adrenal
Virilization - Differential ... Diagnosis Algorithm ... Syndrome Tumor Low ... #Diagnosis #Algorithm ... #endocrinology
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
Diagnosis Algorithm ... Standard Stim test ... primary AI - Low ... #Stimulation #Test ... #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 ... BCM_InternalMed #Adrenal ... #Stimulation #endocrinology
Cushing Syndrome Testing Algorithm INDICATIONS FOR TESTING: • Suspected Cushing syndrome (central obesity, muscle weakness, refractory hypertension) Testing:
Syndrome Testing Algorithm ... Cortisol, Saliva • Low ... dexamethasone suppression test ... #endocrinology ... #Adrenal #Hyperfunction
Adrenal Insufficiency - Differential Diagnosis Workup Algorithm Primary Adrenal Insufficiency: • Autoimmune primary adrenal insufficiency • Adrenoleukodystrophy,
- Differential ... Diagnosis Workup Algorithm ... Insufficiency #Differential ... Diagnosis #Workup #Algorithm ... #endocrinology
Primary Adrenal Insufficiency: • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
between 8 and 9 AM - Low ... aldosterone - Low ... between 8 and 9 AM - Low ... Plasma ACTH - Low ... diagnosis #testing #endocrinology
Hirsutism - Differential Diagnosis Algorithm RAPID ONSET Medications • Steroids • Danazol • Progestin Containing Contraceptives Increased Serum Testosterone
Hirsutism - Differential ... Diagnosis Algorithm ... Serum DHEAS • Adrenal ... Neoplasm SLOW ... #endocrinology
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