QuestionSBA
QuestionChoice
Anti-CCP is an antibody commonly measured to diagnose rheumatoid arthritis. Whilst rheumatoid arthritis sometimes presents with fatigue, it is commonly associated with pain in the small joints and does not usually involve symptoms of increased thirst or areas of hyperpigmentation.
10002256
e
Anti-cyclic citrullinated peptide (anti-CCP)
QuestionChoice
The dexamethasone suppression test is used to diagnose Cushing's syndrome, rather than Addison's disease. Cushing's syndrome classically presents with central obesity, abdominal striae and easy bruising.
10002253
b
Dexamethasone suppression test
QuestionChoice
Although Addison's disease may result in a derangement of electrolytes with hyponatraemia and hyperkalaemia, these electrolyte changes are not specific enough for diagnosis. Instead, the short synacthen test offers a more definitive method of measuring adrenal function and diagnosing Addison's disease.
10002255
d
Urea and electrolytes
QuestionChoice
While tiredness and fatigue may be seen in hypothyroidism, the regions of hyperpigmentation and symptom of increased thirst are highly suggestive of Addison's disease. This condition requires a short synacthen test to measure adrenal function, rather than measuring thyroid function.
10002254
c
Thyroid function tests
QuestionChoice
This patient is presenting with signs and symptoms characteristic of Addison's disease, particularly demonstrated by the areas of hyperpigmentation seen over the buccal mucosa. Addison's disease is a condition in which there is hyposecretion of hormones from the adrenal glands. The gold standard investigation for Addison's disease is the short synacthen test in which synthetic adrenocorticotropic hormone (ACTH) is administered to a patient, and their serum cortisol level is measured afterwards to determine whether their adrenal glands are responding appropriately.
10002252
a
Short synacthen test
Concept
Chapter
2693
3835
Adrenal insufficiency and Addison's Disease
Topic
133
Endocrinology
12997
A 43-year-old female presents to General Practice with symptoms of fatigue, weakness and increased thirst which have developed over the past 4 months. She mentions that her mood has also been quite low recently, and she is eating a bit less than usual. On examination, she is found to have areas of hyperpigmentation, particularly noticeable over the buccal mucosa.

Given the most likely diagnosis, what is the gold standard investigation for this condition?
a