Question

A 40-year-old woman presents with fatigue, dizziness, and hyperpigmentation of the palmar creases. Her BP is 90/60 mmHg. Bloods show Na+ 128 mmol/L, K+ 5.4 mmol/L. A 9am cortisol is 100 nmol/L (160-550). What is the definitive diagnostic investigation?

Accepted Answer

Short Synacthen test (ACTH stimulation test)

Answer

24-hour urinary cortisol

Answer

Dexamethasone suppression test

Answer

Serum renin and aldosterone levels

Answer

MRI adrenal glands

Practice question

A 40-year-old woman presents with fatigue, dizziness, and hyperpigmentation of the palmar creases. Her BP is 90/60 mmHg. Bloods show Na+ 128 mmol/L, K+ 5.4 mmol/L. A 9am cortisol is 100 nmol/L (160-550). What is the definitive diagnostic investigation?