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Lesson 23 Certification Review Quiz

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Question 1 of 10

1. Question
Which patients need to be aware of timing when they’re collecting samples for the comprehensive DUTCH test?
- a. Males
- b. Menstruating females
- c. Post-menopausal females
- d. All of the above
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Question 2 of 10

2. Question
What inputs should patients avoid when taking the DUTCH test?
- a. Unusually low- or high-stress day
- b. Caffeine
- c. Vigorous exercise
- d. All of the above
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Question 3 of 10

3. Question
Patients should avoid all exogenous hormones and steroids right before and during the DUTCH test.
- a. True. Both these drug classes will lead to inaccurate results that can not be used to help with diagnosis or treatment.
- b. False. There is a specific schedule for patients needing hormones, and steroid use depends on whether the clinician wants to know how they impact the patient.
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Question 4 of 10

4. Question
High free cortisol corresponds with which pathological condition(s)?
- a. Inflammation
- b. Perceived stress
- c. Hypertension
- d. Both A and B
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Question 5 of 10

5. Question
Midnight cortisol saliva readings are used as a way of differentiating between Cushing’s disease and pseudo-Cushing’s syndrome.
- a. True. In Cushing’s disease patients, there is virtually no diurnal drop in cortisol, whereas pseudo-Cushing’s patients still have some diurnal rhythm.
- b. False. In Cushing’s, patients have cortisol more than four times above the reference range, whereas in pseudo-Cushing’s it is between two and four times above.
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Question 6 of 10

6. Question
What symptom characterizes patients with flipped diurnal rhythm?
- a. Elevated blood sugar
- b. Difficulty falling/staying asleep and waking up fatigued
- c. Depression
- d. Anorexia
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Question 7 of 10

7. Question
What condition(s) are associated with low free cortisol?
- a. Addison’s disease
- b. Metabolic syndrome
- c. Chronic fatigue syndrome
- d. All of the above
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Question 8 of 10

8. Question
Most cases of very low or flat-line cortisol that you will see are caused by Addison’s disease.
- a. True. Addison’s is the most common cause of very low cortisol; seeing this result means that a patient should be referred to an endocrinologist.
- b. False. Both glucocorticoids and opioids can suppress cortisol production and are more common causes of extremely low cortisol.
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Question 9 of 10

9. Question
The strength of the DUTCH test is differentiation of free and metabolized cortisol.
- a. True. Knowing these levels is vitally important in diagnosing and treating patients.
- b. False. The advantage of the DUTCH test is being able to measure cortisol awakening response in addition to free cortisol.
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Question 10 of 10

10. Question
What biomarker is elevated in obese patients?
- a. DHEA
- b. Total metabolized cortisol
- c. T3 and T4
- d. A & B
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