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Adrenal Insufficiency Differential Diagnosis Algorithm Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis ... ACTH) stimulation test ... baseline ACTH - Secondary ... Insufficiency #Differential ... Diagnosis #Algorithm #endocrinology
Causes of Secondary Hypertension - Differential Diagnosis and Screening Testing Common causes: • Renal parenchymal disease
Causes of Secondary ... Hypertension - Differential ... • Cushing’s syndrome ... Acromegaly #Secondary ... #Hypertension #Differential
Adrenal Insufficiency - Differential Diagnosis Workup Algorithm Primary Adrenal Insufficiency: • Autoimmune primary adrenal insufficiency • Adrenoleukodystrophy,
Adrenal Insufficiency ... - Differential ... or tuberculosis Secondary ... Insufficiency #Differential ... Workup #Algorithm #endocrinology
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
Adrenal Insufficiency ... of primary OR secondary ... Standard Stim test ... #Stimulation #Test ... #Endocrinology
Cushing Syndrome Testing Algorithm INDICATIONS FOR TESTING: • Suspected Cushing syndrome (central obesity, muscle weakness, refractory hypertension) Testing:
Cushing Syndrome ... dexamethasone suppression test ... Hormone • MRI of adrenal ... diagnosis #algorithm #endocrinology ... #Adrenal #Hyperfunction
Primary Adrenal Insufficiency: • ACTH stimulation test - Synthetic ACTH does not stimulate cortisol secretion because
Secondary Adrenal ... - If the secondary ... secretion; in chronic secondary ... administration of CRH; if secondary ... diagnosis #testing #endocrinology
Causes of Adrenal Insufficiency - Differential Diagnosis Algorithm ACTH-Dependent (Secondary): • Pituitary Dysfunction • Hypothalamic Dysfunction ACTH-Independent (Primary):
Insufficiency - Differential ... ACTH-Dependent (Secondary ... Polyglandular Autoimmune Syndrome ... Insufficiency #AI #Differential ... Algorithm #Causes #endocrinology
Diagnosis Adrenal Insufficiency - Algorithm Step 1) Screening Test: 6-8AM Cortisol Level - Early morning cortisol levels
Step 1) Screening Test ... Step 3) Differentiate ... primary vs secondary ... consistent with secondary ... #Stimulation #Endocrinology
Hypercortisolism (Cushing syndrome) - Simplified Differential Diagnosis Algorithm Exogenous (ACTH-independent) Endogenous • ACTH-dependent: - ACTH-secreting
Hypercortisolism (Cushing syndrome ... ) - Simplified Differential ... hyperplasia - Adrenal ... #Differential # ... Diagnosis #Algorithm #endocrinology
Hirsutism & Virilization - Differential Diagnosis Algorithm ADRENAL EXCESS Ovarian • Polycystic Ovarian Syndrome • Hyperthecosis • Tumor Adrenal
Virilization - Differential ... Diagnosis Algorithm ADRENAL ... • Congenital Adrenal ... #Virilization #Differential ... Diagnosis #Algorithm #endocrinology
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