Endocrinology Question 16 Instructor

List three tests used in the diagnosis of Cushing’s syndrome (at least 2/3 should be abnormal to make the diagnosis).

Increased production of cortisol: increased 24 hour urine free cortisol

Lack of suppression: 1 mg dexamethasone suppression test (patient takes 1 mg of dexamethasone between 11 pm- midnight, 8 AM serum cortisol does not suppress to <50 nmol/L (50-140 nmol/L “grey zone”)

Lack of diurnal variation: elevated serum or salivary midnight cortisol

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