Diagnostic Tests and Pharmacology

Important procedures in diagnoses of endocrinological disorders

CT Scan

Computerized tomography scan is used to obtain the anatomic information from the cross-sectional planes of the body by the syn­thesis of the x-ray transmission data. It is used to trace the pathology of the soft body tissues, especially the pancreas, thyroid, and adrenal glands. Generally, such CT scans make use of radiographic contrast mediums to detect any abnormality in the soft tissues.

Fasting blood sugar (FSS)

Fasting blood sugar measures the glucose level in the blood sugar after fasting for atleast 12 hours. A diagnosis of diabetes is made when the fasting blood sugar is consistently over 140. Similarly, if the random blood sugar is consistently above 180, the patient is diagnosed as having diabetes mellitus.

Glucose tolerance test (GTT)

Glucose tolerance test helps in the detection of diabetes mellitus and hypoglycemia. Glu­cose is administered orally or intravenously into the body of a fasting person. In a nor­mal person, the blood sugar quickly rises and then falls to normal standards within 2 hours. In a patient of diabetes mellitus, the increase is too sharp and the fall back to normal a bit prolonged. In a hypoglycemic, de­pressed glucose level may be noticed in 3 to 5 hours.

Insulin tolerance test

Insulin tolerance test is conducted to deter­mine the insulin level in the blood. Insulin is administered into the body and the glucose level is measured at timed intervals. Hypoglycemics will have a lower level of glu­cose and will take longer than in normal people to return to normal glucose levels.

Protein-bound iodine (PSI)

Protein-bound iodine or PBl test is a test used to monitor the thyroid function. This test measures the serum protein-bound io­dine and provides an estimate of the hormone bound to protein in the peripheral blood.

Radioactive iodine uptake (RAIU)

Radioactive iodine uptake test is also known as ¹³¹I uptake test. This is a test of thyroid function in which iodine is administered orally. Then, after the expiry of 24 hours, the amount present in the thyroid gland is measured and compared with the normal values. This test is done to monitor the abil­ity of the gland to take up or absorb the io­dine from the blood. This helps in the detec­tion of thyroid nodules and tumors.

Thyroid echogram

Thyroid echogram is the ultrasound exami­nation of the thyroid. It detects the cysts from the solid nodules. In the first case, the liquid is aspirated from the fluid-filled cysts and surgery is avoided. The reflected sound waves help in the detection of the non-func­tioning thyroid nodules.

Thyroid function tests

Thyroid function tests are done to assess the functioning of the thyroid glands. It also includes the physical exami­nation in addition to laboratory tests. The two thyroid hormones generally tested are triiodothyronine (T₃) and thyroxine (T₄), as well as the thyroid stimulating hormone (TSH). RAIU is also a part of the full thy­roid function test.

Total calcium

Total calcium test measures the presence of calcium in the blood. The measurement of calcium, in turn, indicates the presence or absence of bone or parathyroid disorders. A calcium level of more than the normal indi­cates hyperparathyroidism, and a calcium level of less than the normal indicates hypo­parathyroidism.

Pharmacology Associated With Endocrinology

Anabolic agents

Anabolic agents have the capacity to increase the muscle mass. They are the compounds with androgenic properties and are used in the cases of emaciation, and at times by the athletes to increase the muscle size, strength, and endurance. Some of the examples are Histerone, Depo- Testosterone, Malogen, etc.

Corticosteroids

Corticosteroid is a steroid produced by the adrenal cortex. Corticosteroids are used for adrenal insufficiency. They suppress the in­flammation, allergy, reduce the chances of rejection in transplantation cases, and also treat some kinds of tumors. The two kinds of corticosteroids are mineralocorticoids and glucocorticoid. Aldosterone is a mineralocorticoid. The examples of gluco­corticoids are hydrocortisone, prednisolone, tri­amcinolone, etc.

Antidiabetic and hypoglycemics

Antidiabetic agents are also known as hypoglycemics and they lower the blood sugar level. Drugs like chlorpropamide (Di­abinese), glyburide, pioglitazone (Actos), glipizide (Glucotrol), metformin and phenformin are some examples of hypoglycemics. On the other hand, hyperglycemics increase the blood sugar level and are given in the cases of hy­poglycemia. Glucagon is a popular hyperglycemic agent.