Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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diagnosis adrenal endocrinology insufficiency stimulation hyperthermic hyponatremia hypotonic nephrology physiologic sodium test toxicology toxidromes
Adrenal Insufficiency Diagnosis Algorithm - Evaluation of HPA Axis Response to ACTH Early am cortisol < 3
primary OR secondary AI ... unclear (often the case ... primary or secondary AI ... High = primary AI ... secondary or tertiary AI
Diagnosis Adrenal Insufficiency - Algorithm Step 1) Screening Test: 6-8AM Cortisol Level - Early morning cortisol levels
specificity for AI ... > 15 excludes AI ... have diagnosed AI ... Step 3) Differentiate ... primary vs secondary AI
Causes of Adrenal Insufficiency - Differential Diagnosis Algorithm ACTH-Dependent (Secondary): • Pituitary Dysfunction • Hypothalamic Dysfunction ACTH-Independent (Primary):
Causes of Adrenal ... Insufficiency - Differential ... Diagnosis Algorithm ... ACTH-Dependent ... Insufficiency #AI
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... Renal Losses (AKI ... #Hyponatremia #differential ... #diagnosis #table
Hyperthermic Toxidromes Five toxidromes may present with overlapping features: hyperthermia, rhabdomyolysis, altered mental status/seizures. • Sympathomimetic -
of muscarinic Ach ... pharmacogenetic disease caused ... Hyperthermic #Toxidromes #comparison ... #table #diagnosis ... #differential #
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