Specialist Protocols


INDEX
 (pdf files)

Hypopituitary Section
Basic Pituitary tests   1
TRH 2,3
Checklist for raised prolactin  4
LHRH  5,6
Insulin Tolerance test 7,8
Acromegaly Section
Oral glucose tolerance test 9,10
Adult GH replacement
Prolonged glucagons test 11
Adult GH replacement control 12,13,14
GHRH   12
Arginine 12,13
Diabetes insipidus
Water Deprivation test 15,16,17
Cushings Section 18
Dexamethasone 1mg overnight test  19
Low dose 2 day dexamethasone test 20
PseudoCushings 21
Dexamethasone suppressed CRH test  22,23
Basal testing 24
High dose 2 day dexamethasone test 25
CRh in Cushings  26
Overnight 8mg dexamethasone test 27
Inferior petrosal sampling 28,29
Cushing’s imaging 30
Assessment for cure of Cushing’s  31
Hypoadrenal section
Standard short synacthen test 32,33
Long synacthen test 34
Random cortisol  35
Adrenal autoantibodies 36
CRH in hypoadrenalism   37
Low dose synacthen test  38  
Steroid Biosynthesis chart  39
Congenital adrenal hyperplasia (adults) 40,41
Insulinoma 42,43
Cpeptide suppression test 44,45
Insulinoma localisation  46
Primary Hyperaldosteronism
Screening 47,48
Salt loading test 49,50,51
Selenium cholesterol adrenal scan 52
Phaeochromocytoma
Sensitivity, specificity of tests used  53
Clonidine test  54
Pentolinium test 55
Hypercalcaemic problems
Calcium excretion index 56
Pentagastrin test in medullary thyroid cancer    57
Gastrinoma   58,59
Secretin Test  60
Carcinoid
Urine 5HIAA  61
Scans
MIBG 62
Octreotide 62
Parathyroid scan   63
Thyroid scan 63
Whole body I131 scan 63
Requesting nuclear medicine scans   64,65,66
Operations
Perioperative procedures for thyroidectomy
in thyrotoxicosis                                       
67
Thyroidectomy and hypocalcaemia   68
Parathyroid surgery  69

DISCLAIMER

This guide is produced only for the use of medical staff in the endocrine section of Ninewells Hospital Dundee UK under the express direction, and interpretation of the Clinical Endocrine Specialists and should not be used by anyone else without permission of the specialist doctor in charge of the patient concerned, who should decide the most appropriate test to be performed on their patient taking into account all circumstances of each individual patient, local usage and experience. Variation in local laboratory analysis must also be taken into account in result interpretation if used by others. Please also note that the dosages illustrated (reflect UK version) should always be checked by those performing the test. This guide is not meant to include all tests available and should not be read as the most up to date interpretation of such tests as these are subject to on-going international research and experience in their usage.

No liability whatsoever is accepted if used by others.

Ó NHS Tayside Endocrine Section 2004


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