ENDOCRIN

E
DISORDER
S

Diagnostic Test For Thyroid Disorder

Thyroid function test
1. Thyroid stimulating hormone assay
: hypofunction of the thyroid gland; primary

hypothyroidism
:pituitary disorder; hyperthyroidism
Thyroid antibodies
: thyroiditis
T3T4 Radioimmunoassay
: hyperthyroidism
: hypothyroidism

Diagnostic Test For Thyroid Disorder

Radioactive Iodine Uptake(RAIU)
: hyperthyroidism; urine: hypothyroidism
:hypothyroidism; urine: hyperthyroidism
Patient teaching
Radioactive dose is small and harmless
Contraindicated in pregnancy
Seafoods may elevate results
Drug that may elevate results: barbiturates,

estrogen, lithium, phenothiazines

Drug that may decrease result: Lugols solution,
saturated solution of potassium iodide(SSKI),
antithyroid, cortisone, aspirine, antihistamine.
Collect 24hr urine specimen after oral tracer dose
given
Thyroid is scanned after 24hrs.

Diagnostic Test For Thyroid Disorder

Free thyroxine concentration
T3 risen uptake
Thyroid binding globulines
: hyperthyroidism
: hypothyroidism

Diagnostic Imaging Studies

Thyroid scan
Radioactive iodine taken orally; dose is

harmless
Scanning done after 24hrs
Avoid iodine containing foods, dyes,
medications
Cold nodules: cancer
Hot nodules: benign
UTZ-no special preparation
MRI cannot be done in pt with metal
implants
Assess for allergy to contrast media

Diagnostic Test For Parathyroid Disorders

Total serum calcium
Venous blood is collected
Increase: hyperparathyroidism
Decrease: hypoparathyroidism
Qualitative urinary calcium(Sulkowitch test)
Collect urine specimen
Fine white precipitate should form when Sulkowitch

reagent is added to urine specimen

Absent or decrease precipitate indicates low serum
calcium and hypoparathyroidism
Quantitative Urinary Calcium(Ca deprivation test)
Collect 24 hr urine specimen
Increase: hyperparathyroidism
Decrease: hypoparathyroidism

Diagnostic Test For Parathyroid Disorders

Serum phosphorus
Collect venous blood specimen
Increase: hypoparathyroidism
Decrease: hyperparathyroidism
Serum alkaline phosphatase
Collect venous blood specimen
Increase: hyperparathyroidism
Decrease: hypoparathyroidism
Parathormone (PTH) radioimmunoassay
Collect venous blood
Increase: hyperparathyroidism
When elevated in conjunction with serum calcium

levels, this is the most specific test for

hyperparathyroidism

Diagnostic Test For Adrenocortical Disorders

Cortisol level with dexamethasone

suppression test
Give dexamethasone before phlebotomy to
suppressdiurnal formation of ACTH
Increase: Pituitary tumor, Cushings syndrome
or disease
Decrease Addisons disease
Cortisol plasma level
Fasting is require; the pt should be on bed rest
for 2 hours before the test because activity
increases cortisol level
Increase: cushings disease
Decrease: addisons disease

Diagnostic Test For Adrenocortical Disorders

17-hydroxysteroids

24 hr urine collection to be kept in ice

Increase: Cushing syndrome/disease
Decrease: Addisons disease
17-ketosteroids
24hr urine test; keep collection cold;

may need preservatives

Increase: Cushings syndrome
Decrease: hypofunction of adrenal
gland

Diagnostic Test For Adrenal medulla

Disorders
Vanillymandelic acid test/VMA test
VMA is a metabolite of epinephrine
24hr urine specimen is collected
Instruct the pt to avoid the ff.

medications and foods which may

alter the result: coffee, chocolate,
tea, bananas, vanilla, aspirin
NV: 0.7-6.8mg/24hr

Diagnostic Test For Adrenal medulla

Disorders
Total plasma catecholamine

concentration
the client should lie supine and rest
for 30 minutes
Butterfly needle is inserted
30minutes before the blood specimen
is collected(to prevent the elevation
of catecholamine levels by the stress
of venipuncture)
NV:
1.

epinephrine- 100pg/ml(590pmol/L)

Diagnostic Test For Adrenal medulla

Disorders
Clonidine suppression test
clonidine(catapress), a centrally acting

adrenergic blocker suppresses the release

of catecholamines.
In pheochromocytoma, clonidine does not
suppress the release of catecholamines
Normal response: 2-3hrs after a single oral
dose of clonidine, the total plasma
catecholamine value decreases at least
40% from the pts baseline

CT scan, MRI, UTZ

- To localize the pheochromocytoma

Diagnostic Test For Pancreatic

Disorders
FBS/FBG
NR: 70-110mg/dl
DM: greater than 140mg/dl for 2

readings
2PBBS(2hr postprandial blood
sugar)
Initial blood specimen is withdrawn
100g. Of carbohydrate in diet is taken
by the client
2 after meal, blood specimen is
withdrawn-blood sugar returns to

Diagnostic Test For Pancreatic

Disorders
OGTT/GTT
Take high carbohydrate diet(200-300g) for 3 days
Avoid alcohol, coffee, smoking for 36hrs before

the test
NPO for 10-16 hrs.
Initial blood and urine specimen are collected
150-300g of glucose/orem or IV is given
Series of blood specimen is collected after
administration of glucose(30min.,1hr,2hr,if
required 3hr,4hr,and 5hrs after)
If glucose level peaks at higher than normal at 1
and 2hrs after ingestion or injection of glucose,
and are slower than normal to return to fasting
levels, then DM is confirmed

Diagnostic Test For Pancreatic

Disorders
Glycosylated Hgb(HbAIC)
Most accurate indicator of DM
Reflects serum glucose level for the past 3-

4 months
NV: 4-6%(7%) for non diabetics
The goal for the client with DM is 7.5% or
less
excess glucose in the blood
attaches to hgb
hgb (component of rbc)