Endo Flashcards
MCC adrenal crisis
abrupt withdrawal of steroids
sx adrenal crisis
shock - hypovolemia, Orthostatic Hypotension, hypotension
labs adrenal crisis
hyponatremia
hyperkalemia
hypoglycemia
dx adrenal crisis
primary:
increased ACTH
decreased cortisol
secondary:
decreased ACTH
low cortisol
tx adrenal crisis
normal saline or D5N5
IV steroids
MCC Cushing’s syndrome
long term high dose steroids
4 main causes of cushings
long term high dose steroids
cushings disease - pituitary gland ACTH overproduction - most common ENDOGENOUS cause
ectopic ACTH-producing tumor (small cell)
adrenal tumor
labs cushings
hyperglycemia
hypernatremia
hypokalemia
steps to dx cushings
screening - measure 24 hour urinary free cortisol
differentiating tests - high dose dexamethasone test
imaging
differentiating tests = high dose dexamethasone test and outcomes for cushings syndrome
Cushing dz - increased ACTH + decreased cortisol
Ectopic producing ACTH tumor - increased ACTH + increased cortisol
Adrenal tumor - decreased ACTH + increased cortisol
central vs nephrogenic DI
central - no production of ADH (MC)
nephrogenic - kidneys not responding to ADH
labs DI
increased serum osmolarity
decreased urine osmolality < 300
hypernatremia
tx central DI
desmopressin
tx nephrogenic DI
low solute diet
HCTZ
indomethacin
amiloride
dx DM
FPG >/= 126 (twice)
2 hour glucose tolerance test >/= 200
A1C >/= 6.5
