Question 1

What is the Meaning of Dexamethasone Suppression Test?

Accepted Answer

The Dexamethasone Suppression Test is an endocrine diagnostic procedure assessing adrenal cortisol regulation. It evaluates the body's stress hormone feedback system, identifying potential cortisol excess indicative of Cushing's syndrome. This test differentiates physiological variations from pathological hypercortisolism.

Question 2

What is the Context of Dexamethasone Suppression Test?

Accepted Answer

This test operates within the hypothalamic-pituitary-adrenal (HPA) axis, a critical neuroendocrine system governing stress response and metabolic homeostasis. Hypothalamic CRH stimulates pituitary ACTH secretion, prompting adrenal cortisol production. The test evaluates this negative feedback loop's integrity, specifically pituitary glucocorticoid sensitivity.

Question 3

What is the Significance of Dexamethasone Suppression Test?

Accepted Answer

Clinically, the Dexamethasone Suppression Test is crucial for diagnosing Cushing's syndrome, a disorder of prolonged high cortisol exposure. By assessing HPA axis responsiveness, it distinguishes endogenous cortisol overproduction from mimicking conditions, guiding precise treatment and improving patient outcomes. Results directly influence therapeutic decisions.

Question 4

What is the Mechanism of Dexamethasone Suppression Test?

Accepted Answer

Dexamethasone, a potent synthetic glucocorticoid, mimics natural cortisol's action. Administered, it binds to glucocorticoid receptors in hypothalamus and pituitary, signaling reduced ACTH secretion via negative feedback. In healthy individuals, this suppresses adrenal cortisol production. In Cushing's syndrome, this feedback is impaired, resulting in insufficient cortisol suppression.

Question 5

What is the Application of Dexamethasone Suppression Test?

Accepted Answer

The Dexamethasone Suppression Test is utilized in various forms: overnight low-dose for initial screening, and multi-day low-dose or high-dose for confirmation. For the overnight test, a patient takes a small dexamethasone dose in the evening, with a blood sample collected next morning for cortisol measurement. High-dose protocols differentiate pituitary-dependent Cushing's disease from other hypercortisolism causes.

Question 6

What is the Metric of Dexamethasone Suppression Test?

Accepted Answer

The primary metric is serum cortisol concentration, measured from blood samples drawn before and after dexamethasone. Sometimes, 24-hour urinary free cortisol excretion is also assessed. The degree of cortisol suppression, or its absence, following dexamethasone is compared against established reference ranges for interpretation.

Question 7

What is the Risk of Dexamethasone Suppression Test?

Accepted Answer

While generally safe, the Dexamethasone Suppression Test has considerations. Transient side effects like insomnia, anxiety, or mild gastrointestinal upset can occur. Certain medications, stress, depression, or severe illness may cause false-positive results, indicating cortisol excess. Conversely, some conditions might lead to false negatives. Accurate interpretation requires careful consideration of the patient's clinical picture to avoid misdiagnosis.

Dexamethasone Suppression Test

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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