Cushing’s syndrome is a disorder that occurs when your adrenal glands release too much cortisol. Sometimes, Cushing’s is caused by a hormone-secreting tumor that leads to dysregulation of the hypothalamus-pituitary-adrenal gland axis.  Below, are listed a few tests doctors perform to determine the specific cause of Cushing’s in each patient.  Please read the description of the test and possible results and respond to the prompts below.    1   Measure blood levels of adrenocorticotropic hormone (ACTH).  If ACTH levels are lower than normal, where is the tumor?  How do you know? Remember, this person has high cortisol levels       2   Conduct a corticotropin-releasing hormone (CRH) stimulation test where you inject a shot of CRH.  If this test results in a normal increase in ACTH levels, where is the tumor?  How do you know?    3 Inject a very high-dose of compound that is a cortisol-receptor agonist.  A few hours later measure levels of circulating ACTH.  If the test results in normal suppression of ACTH, where is the tumor?  How do you know?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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Cushing’s syndrome is a disorder that occurs when your adrenal glands release too much cortisol.

Sometimes, Cushing’s is caused by a hormone-secreting tumor that leads to dysregulation of the hypothalamus-pituitary-adrenal gland axis.  Below, are listed a few tests doctors perform to determine the specific cause of Cushing’s in each patient.  Please read the description of the test and possible results and respond to the prompts below.
   1   Measure blood levels of adrenocorticotropic hormone (ACTH).  If ACTH levels are lower than normal, where is the tumor?  How do you know? Remember, this person has high cortisol levels
  
   2   Conduct a corticotropin-releasing hormone (CRH) stimulation test where you inject a shot of CRH.  If this test results in a normal increase in ACTH levels, where is the tumor?  How do you know?
  
3 Inject a very high-dose of compound that is a cortisol-receptor agonist.  A few hours later measure levels of circulating ACTH.  If the test results in normal suppression of ACTH, where is the tumor?  How do you know?

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