FAQ: How Do You Decide What Testing To Do When Screening Patients For Hypercortisolism? скачать в хорошем качестве

FAQ: How Do You Decide What Testing To Do When Screening Patients For Hypercortisolism?

In this educational endocrinology update, Amy Burmesh, PA-C, from the Medical College of Wisconsin shares a practical, step-by-step approach to screening for hypercortisolism and Cushing syndrome in clinical practice. She reviews the three primary screening tests for cortisol excess: the 24-hour urine free cortisol, late-night salivary cortisol (two samples), and the 1 mg overnight dexamethasone suppression test. The discussion highlights the strengths and limitations of each test, including sensitivity and specificity, patient compliance challenges, and when each option is most appropriate. Learn why the dexamethasone suppression test offers the highest diagnostic accuracy, when late-night salivary cortisol may be unreliable (such as in shift workers), and why oral estrogen therapy can interfere with interpretation of serum cortisol results. This episode also explains the role of ACTH and DHEAS levels in differentiating ACTH-dependent vs ACTH-independent hypercortisolism and identifying adrenal sources of cortisol excess. Designed for advanced practice providers, endocrinology clinicians, and primary care professionals, this practical overview provides clear guidance on evaluating suspected Cushing syndrome and selecting the right screening strategy for your patients.