Sandbox:Amd: Difference between revisions
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* Sodium in urine typically >20 mEq/ | * Sodium in urine typically >20 mEq/ | ||
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* Mild- Fluid restriction | |||
* Moderate- [[Loop diuretics]] | |||
* Severe Hypertonic (3%) [[saline]] | |||
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|- | |- | ||
|Salt- | |Salt-depletion nephritis | ||
|✔ | |✔ | ||
|– | |– | ||
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* [[Oliguria]] | * [[Oliguria]] | ||
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|✔ | |||
|↑ | |||
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| | |<15:1 [[BUN-to-creatinine ratio|BUN:CR]] | ||
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Revision as of 20:14, 26 September 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]
Adrenal Insufficiency
Disease | Clinical history/findings | Causes | Investigations/
Laboratory findings |
Medical management | Surgical management | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Hypotension | Skin
pigmentation/ findings |
Fatigue | Anorexia/
Weightloss |
Abdominal pain | Muscle
weakness |
Other history/
findings |
Hypo
natremia |
Cortisol levels | Gold Standard | Other | ||||
Differentiating amongst adrenal insufficiencies | ||||||||||||||
Primary adrenal | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ |
|
✔ | ↓ | Cosyntropin/ ACTH stimulation test | ||||
Secondary adrenal
insufficiency |
± | – | ✔ | ✔ | – | ± |
|
|
– | Normal | Cosyntropin/ ACTH stimulation test | CT scan/ MRI scan showing pituitary causes | ||
Acute adrenal insufficiency/ Acute adrenal crisis | ↓↓ | ± | ✔ | ✔ | ✔ | ± |
|
✔ | Normal to Low | Cosyntropin/ ACTH stimulation test |
|
|
||
Differentiating Adrenal Insufficiency from other diseases | ||||||||||||||
Syndrome of inappropriate antidiuretic hormone (SIADH) | – | – | – | – | – | – |
|
✔ | Normal | Water deprivation test |
|
|
||
Salt-depletion nephritis | ✔ | – | – | – | ✔ Flank pain | – | ✔ | ↑ | <15:1 BUN:CR | |||||