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