High Yield: Adrenal Gland Diseases for Step 3

• The diagnosis of primary adrenal insufficiency: 1. serum cortisol level is low and the ACTH level is high; 2. the plasma aldosterone level is also low.  Note: these are differentials for secondary AI.
  
• An elevated serum cortisol level associated with a suppressed adrenocorticotropic hormone level  ---> cortisol-producing adrenal tumor
• Adrenal incidentaloma: functioning or great than 6 cm need surgical resection. Otherwise monitoring. Evaluation including hormone levels, imaging studies, and benign vs. malignant.