Tests

Question 1

Test for adrenal insufficiency

Answer 1

Short synacthen test
Measure cortisol then give IV or IM ACTH then measure again in 30mins
Normal should be 250 up to 550nmol/L

Question 2

What is Cushing’s Disease?

Answer 2

Pituitary cause of increased ACTH

Question 3

What type of test would you do for primary hyperaldosteronism

Answer 3

Suppression test after measuring aldosterone/renin ratio

Question 4

Random glucose for diabetes?

Answer 4

> 11mmol/L with symptoms

2x >11mmol/L without symptoms

Question 5

What type of test would you do for Cushing’s syndrome

Answer 5

Suppression test

Question 6

What is the definitive test for Cushing’s?

Answer 6

Low dose dexamethasone test
Give 2mg a day for two days. By end the cortisol should be under 50
Definitely have Cushing’s if over 130

Question 7

What screening tests are for Cushing’s?

Answer 7

Overnight suppression test: give 1mg dexamethasone at midnight and measure cortisol in morning, should be down to <50
Urine free cortisol for 24hrs should be under 250
Diurnal variation: midnight should be less than morning cortisol

Question 8

Tests for primary hyperaldosteronism?

Answer 8

Measure aldosterone:renin, if raised then do saline suppression test
Give 2L of saline and aldosterone should suppress by >50%

Question 9

Fasting glucose for diabetes diagnosis?

Answer 9

> 7mmol/L

Question 10

What type of test would you do for adrenal insufficiency?

Answer 10

stimulating test