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Diagnostic Test for Endocrine Disorders1.Diagnostic Test of Thyroid Disorder Thy Function Testa.Thyroid – Stimulation hormone assay: Hypofunction of thyroid gland; primary hypothyroidism.: Pituitary disorder; hyperthyroidism. b.Radioactive Iodine Uptake( RAIU):Hyperthyroidism; urine: hypothyroidism:Hyperthyroidisms; urine: hyperthyroidism.-Patient Teaching:= Radioactive dose is small and harmless.= Contraindicated in pregnancy.= Seafood’s may elevate result.= Drugs that may elevate result: barbiturates, estrogen, lithiumPhenothiazines.= Drug that may decrease result: Lugol’s solution, saturatedSolution of potassium iodine (SSKI), antithyroid, cortisone,aspirin antihistamines.= Collect 24-hour urine specimen after oral trace dose give.= Thyroid is scanned after 24 hours.c.Thyroid antibodies: thyroiditisd.T3T4 Radioimmunoassay: Hyperthyroidism: Hypothyroidisme.Free Thyroxine ConcentrationT3 Resin UptakeThyroid Binding Globulins: Hyperthyroidism: Hypothyroidism Diagnostic Imaging Stuadiesa.Thyroid scan-Radioactive iodine taken orally; dose is harmless.-Scanning done after 24 hour.-Avoid iodine containing foods, dyes, medication.-Cold nodules: cancer -Hot nodules” bening b.Ultrasound- No special preparation.c.Magnetic Resonance Imaging- Test cannot be done in client with metal implants( e.g.,Pacemakers, arthroplasties, skull plates).
 
 -Assess for allergy to contrast media.d.Computed Tomography-If contrast medium is used, note allergy history.2.Diagnostic Test of Parathyroid Disordersa.Total serum calcium-Venous blood is collected.-:Hyperparathyroidism-:Hypoparathyroidism b.Qualitative Urinary Calcium( Sulkowitch test )-Collect urine specimen.-Fine white precipitate should form when Sulkowitch reagent isadded to urine specimen.-Absent or decreased precipitate indicate low serum calciumand hypoparathyroidism.c.Quantitative Urinary Calcium ( Calcium Deprivation Test)-Collect 24 hours urine specimen.-:Hyperparathyroidism-:Hypoparathyroidismd.Serum Phosphorous-Collection Venous blood Specimen.-:Hypoparathyroidism-:Hyperparathyroidisme.Serum Alkaline Phosphatase-Collection Venous blood Specimen.-:Hyperparathyroidism-:Hypoparathyroidismf.Parathormore (PTH) Radioimmunoassay-Collection venous blood-: Hyperparathyroidism- When elevated in conjunction with serum calcium levels, thisIs the most specific test for Hyperparathyroidism.3. Diagnostic Test of Adrenocortical Disorder a. Cortisol level with dexamethasone soppression test- Give dexamethasone before phlebotomy to suppress diurnalformation of ACTH.- :Pituitary tumor, Cushing’s syndrome or disease.-Addision’s disease.b. Cortisol plasma level- Fasting is required; the patient should be on bed rest for 2 hoursbefore the test because activity increases cortisol level.-:Cushing’s Disease.-:Addison’s Disease.
 
c. 17- Hydroxysteroids- 24 Hour Urine collection to be kept on ice.- :Cushing’s syndrome or disease.- :Addison’s Disease.d. 17-kefosteroids-24 hour urine test; keep collection cold; may need preservative.- :Cushing’s syndrome.- :Hypofunction of adrenal gland.4. Diagnostic Tests of Adrenal Medullary Disordersa. Vanillymandelic acid Test (VMA test)- VMA is a metabolite of apinephrine.- 24 hour urine specimen is collected- intruct the client to avoid the following medication and foodsWhich may alter the result:*Coffee*Chocolate*Tea*Bananas*Vanilla*Aspirin- Normal Value: 0.7 – 6.8mg/24hr.b. Total plasma Catecholamine Concentration- The client should lie supine and rest for 30 minutes.- Butterfly needle is inserted 30 minutes before blood specimenis collected(to prevent elevation of catecholamine levels bythe stress of venipuncture).c. Clonidine Suppression Test.- Clonidine (Catapress), a centrally acting adrenergic blocker Suppresses the release of catecholamines.- In pheochromocytoma, clonidine does not suppress theRelease of catecholamines.- Normal Response: 2 to 3 hours after a single oral dose of Clonidine the total plasma catecholamine value decreases atat least 40% from the client’s baseline.d. CT Scan, MRI and Ultrasound- To localize the pheochromocytoma.5. Dianostic Test of Pancreatic Disorder (Diabetes Mellitus)a. FBS (Fasting Blood Sugar); FBG(Fasting Blood Glucose):- Normal: 70 – 110 mg/dl.- DM: ↑140 mg/dl for 2 readings.b. 2 PBBS (2hr. Postprandial Blood Sugar)-initial blood specimen in with drawn.-100 g. of carbohydrate in diet is taken by the client.-2 after meal, blood specimen is withdrawn – blood sugar Return to normal level.c. OGTT/GTT (Oral Glucose Tolerance Test)
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