Sandbox:Amd: Difference between revisions

Revision as of 20:24, 25 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Disease	Clinical history/findings							Causes	Investigations/ Laboratory findings			Medical management
	Hypotension	Skin pigmentation/ findings	Fatigue	Anorexia/ Weightloss	Abdominal pain	Muscle weakness	Other history/ findings	Causes	Hypo natremia	Cortisol levels	Gold Standard
Differentiating amongst adrenal insufficiencies
Primary adrenal insufficiency	✔	✔	✔	✔	✔	✔		Autoimmune/idiopathic Infections- Tuberculosis, histoplasmosis	✔	↓	Cosyntropin/ ACTH stimulation test
Secondary adrenal insufficiency	±	-–	✔	✔	-–		Hypoglycemia (more than primary adrenal insufficiency) Signs of pituitary tumor- Headache, visual field defects (bitemporal hemianopsia)	Hypopituitarism- Tumors, infections. hemorrhage/trauma Drugs- Chronic steroid therapy and its withdrawal, Opiates Genetic- Combined pituitary hormone deficiency (CPHD), POMC (Proopiomelanocortin) gene deficiency	-–	Normal	Cosyntropin/ ACTH stimulation test
Acute adrenal insufficiency	↓↓	±	✔	✔	✔	±	Signs of shock Altered mental status/ Loss of consciousness/ Coma Fever	Infection Tumor				I/V saline
Differentiating Adrenal Insufficiency from other diseases

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-|Cosyntropin/
+|Cosyntropin/ ACTH stimulation test
-ACTH stimulation test
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 |'''Secondary adrenal'''
 '''insufficiency'''
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+* [[Hypoglycemia]] (more than primary adrenal insufficiency)
+* Signs of pituitary tumor- [[Headache]], visual field defects ([[bitemporal hemianopsia]])
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 * [[Hypopituitarism]]- Tumors, infections. hemorrhage/trauma
 * Drugs- Chronic [[steroid]] therapy and its withdrawal, [[Opiates]]
-* [[Genetics|Genetic]]- Combined pituitary hormone deficiency (CPHD), [[POMC]] ([[Proopiomelanocortin]]) gene deficiency<ref name="pmid24354022">{{cite journal |vauthors=Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K, Challis BG, Millington GWM |title= |journal= |volume= |issue= |pages= |year= |pmid=24354022 |doi= |url=}}</ref>
+* [[Genetics|Genetic]]- Combined pituitary hormone deficiency (CPHD), [[POMC]] ([[Proopiomelanocortin]]) gene deficiency
 |<nowiki>-–</nowiki>
 |Normal
-|
+|Cosyntropin/ ACTH stimulation test
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+* I/V saline
+*
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