Questions and Answers
Which of the following is a common finding in adrenal insufficiency, specifically Addison's disease?
What is the main purpose of the short synacthen test in diagnosing Addison's disease?
What would a typical cortisol level be at 0 minutes in the synacthen test for someone with Addison's disease?
Which test is commonly used to diagnose acromegaly?
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What happens to growth hormone levels during the oral glucose suppression test in individuals with acromegaly?
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Which of the following tests is used to further evaluate cortisol suppression after administering dexamethasone?
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What role does IGF-1 play in the management of acromegaly?
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Which condition is characterized by excess growth hormone in adults?
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Study Notes
Adrenal Insufficiency (Addison's Disease)
- Primary adrenal insufficiency, also known as Addison's disease, is rare but can be fatal due to cortisol deficiency.
- Causes include autoimmune diseases or damage from infections like tuberculosis.
- Treatment involves steroid replacement therapy.
Diagnosis of Addison's Disease
- Diagnosis requires measurement of cortisol levels and serum electrolytes.
- Common findings include low sodium and high potassium levels, with possible low glucose.
- A short synacthen test assesses adrenal function: sample cortisol before the test and at 30 and 60 minutes post-administration.
- Addison's disease shows a baseline cortisol of 50 nmol/L or lower in response to synacthen.
Cushing's Syndrome Diagnosis
- Random cortisol tests are unreliable due to variability from stress and other factors.
- If initial tests are inconclusive, a 24-hour urine cortisol excretion test can help diagnose Cushing's syndrome.
- A prolonged dexamethasone suppression test examines cortisol suppression efficiency 1 or 2 days after dexamethasone administration.
- Imaging studies (CT/MRI scans) are effective in identifying tumors associated with Cushing's syndrome.
Acromegaly
- Acromegaly results from excessive growth hormone (GH) production in adults, leading to symptoms like glucose intolerance.
- Growth Hormone-Releasing Hormone (GHRH) levels are elevated due to increased GH production.
- Random GH levels are not diagnostic due to their episodic nature.
Diagnostic Tests for Acromegaly
- The oral glucose suppression test measures GH's response to glucose; GH levels remain unchanged or increase in acromegaly.
- Insulin-like Growth Factor 1 (IGF-1), which is elevated in acromegaly, is useful for monitoring treatment progress.
Growth Hormone Deficiency in Children
- A rare cause of short stature in children can be due to growth hormone deficiency, which may be congenital or result from pituitary failure later.
- Initial diagnostic tests include measuring IGF-1 and a 24-hour urine GH assessment.
- A glucagon stimulation test can confirm GH deficiency; inadequate GH rise indicates deficiency.
Treatment for Growth Hormone Deficiency
- The primary treatment is synthetic growth hormone administration.
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Description
Explore the critical aspects of Addison's disease in this quiz. Learn about the causes, symptoms, diagnosis, and treatment options for primary adrenal insufficiency. Test your knowledge on the hormonal imbalances and diagnostic tests associated with this rare but serious condition.
