Mixed Meal Hypoglycemia Test
If a patient is symptomatic and blood glucose is normal, diagnosis of postprandial syndrome can be made. Caveats: An oral glucose tolerance test should never be used for the evaluation…
ENDOCRINOLOGY
Levothyroxine Absorption Test
Precautions: Supervise patient continuously during the procedure. Interpretation: Absorption is calculated by using the following formula [1]: Volume of distribution (Vd) in deciliters: 4.42 × body mass index [1]. More than 60–80 %…
Thyroid Cancer Follow-Up: Thyrogen Injection with Scan With/Without Treatment
− 14 Day and date Start with low-iodine diet. Continue this diet until after you have your blood work done on Day 5 1 Day and date Have labs (TSH and…
ACTH Stimulation Test for Late Onset (Nonclassic) 21-Hydroxylase Deficiency
Assay for 17 OHP: Radioimmunoassay (RIA) . Interpretation: With late onset 21-hydroxylase deficiency, the absolute value of 17-hydroxyprogesterone at 60 min sample is > 10 ng/dl [2, 3]. Caveats: Baseline androgen levels return…
Glucagon Stimulation Test for GHD (GST)
Assay for GH: Immunoenzymatic Precautions: Nausea (30 %), vomiting/retching (10 %), and headaches (10 %) may occur during and after the test. (Administration of intravenous antiemetics can be considered.) Late hypoglycemia may rarely…
ACTH Stimulation Test for Adrenal Insufficiency with Free Cortisol Levels
Assay for Cortisol: Electrochemiluminescence immunoassay (ECLIA) . Precautions: Cosyntropin is category C of pregnancy. Interpretation: Normal response: Peak stimulated cortisol value > 1.2 mcg/dl [3, 4] at 30 or 60 min. Most…
Combined CRH Dexamethasone Suppression Test
Assay for Cortisol: Chemiluminescence Immunoassay (CLIA) . Precautions: None. Interpretation: Serum cortisol concentration more than 1.4 mcg/dl at 15 min after Combined Dex-CRH test is suggestive of Cushing’s syndrome [1]. Caveats: We…
Intravenous Saline Suppression Test
Assay for Aldosterone: Enzymatic radioimmunoassay (RIA). Precautions: Do not perform this test in patients with severe uncontrolled hypertension, renal insufficiency, cardiac insufficiency, cardiacarrhythmia, or severe hypokalemia. Interpretation: Postinfusion plasma aldosterone…
Captopril Challenge Test
50 mg of captopril. Blood tubes for plasma renin activity (PRA) and aldosterone. Assay for PRA and Aldosterone: Radioimmunoassay. Precautions: Monitor BP hourly. Interpretation: Plasma aldosterone is normally suppressed by captopril…
GHRH–Arginine GH Stimulation Test
Confirm the medication doses with physician. Assay for GH: GH:Immunoenzymatic Assay Precautions: Facial flushing occurs immediately after administration of GHRH in about half of the patients. Paresthesias, nausea, and abnormal…
