45. Clinical biochemistry of the disorders of adrenal medulla/cortex

From greek.doctor
  • Adrenal cortex
    • Hypofunction
      • Hyponatraemia
      • Hyperkalaemia
      • Metabolic acidosis
      • Addison disease
        • Low cortisol
        • ACTH high
        • ACTH stimulation -> cortisol remains low (usually rises)
      • Secondary/tertiary adrenal insufficiency
        • Low cortisol
        • ACTH low
        • ACTH stimulation -> cortisol increases
      • Congenital adrenal hyperplasia
        • High levels of 17-hydroxyprogesterone
    • Hyperfunction
      • Hypernatraemia
      • Hypokalaemia
      • Metabolic alkalosis
      • Cushing syndrome
        • 24 hour urine cortisol high
        • Low-dose dexamethasone suppression test -> cortisol remains high (usually decreases)
        • Cushing disease
          • High-dose dexamethasone -> cortisol decreases
        • Ectopic ACTH production
          • High-dose dexamethasone -> no change in cortisol
  • Adrenal medulla
    • Phaeochromocytoma
      • Metanephrines and catecholamines in 24 hour urine
      • Genetic testing