Endocrine Labs and Dx pt. 2 (Exam 3) Flashcards
Water Deprivation Test (ADH stimulation test)
Used to differentiate causes of diabetes insipidus (neurogenic - nephrogenic - psychogenic)
ADH (vasopressin) is administered
Monitor urine output/specific gravity + serum osmolality every hour or two during test
What is monitored during water deprivation test?
Urine output
Urine specific gravity
Serum osmolality
Serum Cortisol Level (test)
Evaluates status of adrenal cortex function
Serum Cortisol is affected by
Diurnal Variation (high in AM)
Stress
Urine Cortisol
24 hour urine collection that measures the amount that is excreted via urinary tract
Serum Aldosterone Level (Test)
Used to assess for hyperaldosteronism
Maintain assigned position x 2 hours
Levels varying, depending on position
What does aldosterone do?
Regulates sodium
Increase in aldosterone will
Increase sodium retention that will increase fluid retention and increase blood volume
Increase in ADH and INcrease in Aldosterone will ultimately
Increase the fluid volume in the intravascular system
When serum aldosterone level is drawn the patient must
Assign a certain position for 2 hours because aldosterone levels vary depending on position
ATCH test: (3)
Serum ACTH
ACTH “stimulation” Give synthetic ACTH
Suppression Test (dexamethasone given)
What do ACTH test evaluate?
Adrenal (cortex) Function
Thyroid Studies
TSH - T3 - T4
Thyroid ultrasound
Thyroid Scan
Radioactive iodine uptake
Thyroid Serum Blood test
TSH - T3 - T4
Serum TSH level (Test)
Most sensitive test used for evaluation thyroid dysfunction
Serum T3 and T4 level (Test)
Evaluation thyroid function and monitoring thyroid therapy response
Thyroid Scan
Used to evaluate nodules in the thyroid
Radioactive isotopes given PO or IV
Scanner passes overy Thyroid:
-Benign (warm spot = uptake)
-Malignant (cold spot = No uptake)
Is reaction to iodine common with thyroid scans?
No, it is very rare
If patient has thyroid scan with iodine they are encouraged to
force fluid 24-48 hours after
Radioactive Iodine Uptake Test (RAIU)
Provides direct measure of thyroid activity
Radioactive iodine administered PO or IV
Radioactive Iodine Uptake Test Evaluates
Function of nodules
With Radioactive Iodine Uptake, uptake is measured at what intervals?
2-4 hrs, and 24 hrs
Values expressed in percentages
Test Related to Pancreas
Fasting blood glucose
Casual blood glucose
Glycosylated Hemoglobin (HbA1C)
Oral Glucose Tolerance Test
What is normal for fasting blood glucose?
< 126 mg / dL
What is the normal for casual blood glucose?
Normal <200 mg / dL
Glycosylated Hemoglobin (HbA1C)
Indicator for AVERAGE glucose level over the past 120 days (3 months)
Used for diagnosis and to evaluate effectiveness of interventions
Normal (HbA1C)
4-6%
What is considered diabetic when it comes to A1C
Anything greater than 6.5%
Acceptable HbA1C range for those with diagnosed diabetes
6-8%
Target 7%
Urine Study Related to Pancreas
Ketone level
High ketones are associated with Hyperglycemia
> 300 mg/dL is considered a medical emergency (DKA)
Diagnostic Criteria from the ADA S/S
Random Glucose Test:
Considered Diabetes
> 200 mg/dL
Done anytime of the day without regard to time since last meal
Fasting plasma glucose:
Prediabetes Level
Diabetes Level
Pre = >100 mg/dL & <126mg/dL
Diabetes = >126mg/dL
NO caloric Intake for at least 8 hours
2 hour plasma glucose
Prediabetes
Diabetes
Pre = >140 & <200
Diabetes = >200
HbA1C
Prediabetes
Diabetes
Pre = 5.7-6.4%
Diabetes = >6.5%
