Adrenal Flashcards
1
Q
What are 3 initial tests in workup of adrenal mass?
A
Aldosterone-plasma renin activity and aldosterone ratio
Cortisol-low dose Dex suppression test (1mg at 11pm, cortisol in morning)
Pheo- plasma metanephrines, 24hr urine metanephrines
2
Q
If your low dose dex test comes back positive (>5), what’s next?
A
need a high dose dex suppression test and an ACTH level
3
Q
If you have a positive low dose dex test, and an elevated ACTH, what does this suggest?
A
Suggests an “ACTH-dependent” cause - can come from the pituitary (which WILL suppress with a high-dose Dex test) or can come from somewhere else (lung cancer) - which WON’T suppress on a high-dose dex test.
