Diagnostic Test for Endocrine Disorders

1. Diagnostic Test of Thyroid Disorder

Thy Function Test
a. 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, lithium
Phenothiazines.
= Drug that may decrease result: Lugol’s solution, saturated
Solution 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
: thyroiditis
d. T3T4 Radioimmunoassay
: Hyperthyroidism
: Hypothyroidism
e. Free Thyroxine Concentration
T3 Resin Uptake
Thyroid Binding Globulins
: Hyperthyroidism
: Hypothyroidism

Diagnostic Imaging Stuadies

a. 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 Disorders
a. 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 is
added to urine specimen.
- Absent or decreased precipitate indicate low serum calcium
and hypoparathyroidism.
c. Quantitative Urinary Calcium ( Calcium Deprivation Test)
- Collect 24 hours urine specimen.
- :Hyperparathyroidism
- :Hypoparathyroidism
d. Serum Phosphorous
- Collection Venous blood Specimen.
- :Hypoparathyroidism
- :Hyperparathyroidism
e. Serum Alkaline Phosphatase
- Collection Venous blood Specimen.
- :Hyperparathyroidism
- :Hypoparathyroidism
f. Parathormore (PTH) Radioimmunoassay
- Collection venous blood
- : Hyperparathyroidism
- When elevated in conjunction with serum calcium levels, this
Is 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 diurnal
formation 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 hours
before 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 Disorders
a. 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 foods
Which 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 specimen
is collected(to prevent elevation of catecholamine levels by
the 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 the
Release of catecholamines.
- Normal Response: 2 to 3 hours after a single oral dose of
Clonidine the total plasma catecholamine value decreases at
at 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)
 Hgb
Excess (component
Glucose
Attaches in ofthe
rbc bloood
to hemoglobin )
Lifespan is 90-120 days

-Take high carbohydrate diet (200 to 300g) for 3 days.

-Avoid alcohol, coffee and smoking for 36 hours before the
test.
-NPO for 10 to 16 hours.
-initial blood and urine specimen are collected.
-150 to 300 g. of glucose per orem or IV is given.
- Series of blood specimen is collected after administration
of glucose (30 min., 1 hour,2hour, if required 3 hour,4hour,
and 5hours after.)
- If glucose levels peak at the higher than normal at 1 and 2
hours after ingestion or injection of glucose, and slower
then normal to return to fasting levels, then DM(diabetes
mellitus) is confirmed.
-Done when result of FBS an 2 PPBS are borderline( higher
normal).
d.Glycosylated Hgb(HbAIC)
-Most accurate indicate of DM (diabetes mellitus).
-Reflects serum glucose level for the past 3 to 4 month
-NV is 4% to 6%(up to 7%) for nondiabetics.
-the goal for the client with DM is 7 .5% or less