1
Q
OGTT
A
oral glucose tolerance test: DM insulin response
2
Q
GnRH stimulating test
A
for central precocious puberty: normal prepub won’t have raised LH in resposne; post-pub or CPP would
3
Q
Suppression test
A
- negative feedback by cortisol on ACTH secretion: dex (dexamethasone suppression test) for Cushing’s disease/syndrome
- Dex is potent glucocorticoid analogue and will attenuate ACTH secretion and thus cortisol in a healthy hypothalamic-pit axis
- Pts with Cushing disease:
- have higher than normal threshold for negative fb on ACTH for cortisol
- low-dose dex: cortisol remains high in Cushing’s pts
- high-dose dex: knock down cortisol in a bit in most pts with Cushings disease
- if positive, go check for a tumor
- Pts with Cushing syndrome:
- high dose dex: may not reduce ACTH in event of ectopic ACTH produciton or otherwise exogenous ACTH
- -Cushing syndrome: any abnormal elevation in cortisol
- -Cushing disease: elevation in cortisol bc pit adenoma; ACTH excess
4
Q
What would make you suspicious someone has hypercortisolism?
A
- hyperglycemia
- also:
- Cushings
- Acromegaly
- DM1, DM2
- also:
- obesity
- muscle wasting
- stria on skin, bruising
- bone wasting
