Understanding The Dexamethasone Suppression Test

Рет қаралды 320,195

7 жыл бұрын

A simple explanation of why you would do a dexamethasone suppression test and how to interpret the results.
Zero to Finals Medicine book:
UK: www.amazon.co.uk/dp/1091859892
US: www.amazon.com/dp/1091859892
Zero to Finals Paediatrics book:
UK: www.amazon.co.uk/dp/1080142827
US: www.amazon.com/dp/1080142827
Zero to Finals Obstetrics and Gynaecology book:
UK: www.amazon.co.uk/dp/B08K4K2WQB
US: www.amazon.com/dp/B08K4K2WQB
Website: www.zerotofinals.com
Notes: www.zerotofinals.com/learn
Multiple Choice Questions: www.zerotofinals.com/test
Instagram: / zerotofinals
Facebook: / zerotofinals
Twitter: / zerotofinals
DISCLAIMER: This video is for education and entertainment only, and is not medical advice. This video should NOT be used for medical advice or to guide clinical practice. The Zero to Finals content should not be used in any way to guide medical decision making. Zero to Finals takes no responsibility for any actions taken or not taken based on the information provided. Local and national guidelines and senior clinicians are there to help you make decisions, not KZfaq videos. If you need medical advice or information, seek it from an appropriately trained and licenced doctor or healthcare provider that can address your individual needs. Zero to Finals cannot guarantee the accuracy of information in this video. Please highlight any errors you notice in the comments below - thank you.

Пікірлер: 342

@chrisnjoku2777 3 жыл бұрын

Who is here after watching this video some months back and feeling like they have 'finally' understood the DMST and will never forget it only to come back to watch it again.

@ZeroToFinals 3 жыл бұрын

haha! I made the video and I still have to come back to remind myself. It is a tricky topic

@saleemullah4991 3 жыл бұрын

🖐️🖐️

@qwertyuioparya 2 жыл бұрын

@alviyt6627 Жыл бұрын

I am here for the same reason 😂

@iknowthatiknownot 6 ай бұрын

@lawyerdoctor 3 жыл бұрын

Brilliant. You explained this test 100% better than the pharm professor at my medical school. I was confused and now I understand, thank you!

@amandamccrary9773 5 жыл бұрын

I really couldn't get this through my head until now. Thank you.

@ZeroToFinals 5 жыл бұрын

glad to help!

@rmacd Жыл бұрын

I've gone through 3 years of medical school and it's literally taken me this video for everything to click into place

@billkuo1 5 жыл бұрын

My notes on steps with dexamethasone suppression test (with Fahad's input) • 1 mg of dexamethasone (low dose suppression test) is given at 10pm at night and blood levels of cortisol and ACTH are measured at 9am next morning • If the person have normal CRH-ACTH-cortisol function, ACTH would be suppressed via negative feedback • low ACTH -> low cortisol • Blood test would show low cortisol • If blood test show normal or elevated cortisol levels, it indicates Cushing syndrome, ACTH should then be measured (note: measure cortisol first because measuring ACTH first cannot rule out Cushing syndrome) • If Cushing syndrome is caused by primary causes, Cortisol would remain high, but ACTH will react to suppression ie. Low ACTH in adrenal adenoma, or exogenous steroids • If syndrome is caused by excess ACTH: Cushing disease (pituitary adenoma), or ectopic ACTH in paraneoplastic syndromes in SCLC, ACTH will remain high or normal • In this case, high dose suppression test is used where 8mg of dexamethasone is given at 10pm and ACTH is measured next morning • High dose dexamethasone is able to suppress ACTH release from the pituitary, therefore, low ACTH would mean pituitary adenoma / Cushing disease (cortisol would be low as well because ACTH is low) • ACTH remaining high would mean it is not released at the pituitary, and ectopic ACTH would be likely

@joleneong8173 2 жыл бұрын

you are a legend!! this saved my life!!

@zwenyinyihtun6988 2 жыл бұрын

The best one

@Callmeperrys Жыл бұрын

Finally after years of studying this I get it

@trafficjon400 10 ай бұрын

Dexamethasone tortured my life for over 6 years now? 1 injection for Swelling from a product effected my adrenal Cortisol very badly by still shaking while waking and told my cortisole is sopposed to react with waking but is not. it takes the life out of a person and waking in hell . if your a believer in God dexamethasone will take the belief away for sure when you feel like your in hell unexplainable. ENDOCRINOLOGIST i dare not to see because they don't really know the correct levels of treating with this hormone. Any body abused and have emotional problems better keep far from Steroids Corticasteroids that induce PTSD or any kind of fear will be doubled in Severity.

@davidoconnor4028 4 жыл бұрын

made everything so much clearer, thank you

@meliketopaloglu3308 3 жыл бұрын

Oh wow, you are making everything so easy , thank you so much, I did not even have internet during my medical school , I wish I had and watched you 🙌🏼

@s101077 3 жыл бұрын

🙌🏼

@jehangiri6 5 жыл бұрын

Once the Low Dose Dexamethasone Suppression Test is positive , the next step is to measure Serum ACTH levels , if the are low , its either exogenous steroid (most common cause) or Adrenal adenoma , you do not need to do High dose suppression in this situation. However if Serum ACTH is high after a positive low dose suppression , then you do High dose suppression test to determine whether its Cushing Disease (Cortisol Suppressed) or Lung Cancer(Cortisol Unchanged ). I like your channel though , from Pakistan.

@ZeroToFinals 5 жыл бұрын

Thanks for your comment Fahad. You are right!

@faisalhaqparast357 5 жыл бұрын

Now i understood from your comment

@LostSmiler 4 жыл бұрын

legend man. Thanks

@adamjohnzon 2 жыл бұрын

very helpful, thanks!

@fahadafridi8173 2 жыл бұрын

sher ye sher

@amymunro1419 3 жыл бұрын

This is such a great explanation of the test - thank you!

@krisshassebrock7518 5 жыл бұрын

Finally I'm getting the answers to my questions!! Thank you so very much

@ZeroToFinals 5 жыл бұрын

No problem, glad to help Kriss

@Shubham-td9yz 3 жыл бұрын

This was easy to understand.... thanks for making it crystal clear 😇

@abifarinopeyemi1688 Жыл бұрын

This was broken down to bits and really helpful. Thank you.

@ZeroToFinals Жыл бұрын

Glad it was helpful!

@KrissAstronomist 7 жыл бұрын

A great explanation, thank you!

@leenahmed147 Жыл бұрын

The summary at the end was so helpful, Thank you!

@adissabooz7131 6 жыл бұрын

Muchas gracias, súper práctico y explícito!!! I like it

@iqrakanwal6438 4 жыл бұрын

Best explanation of Dexamethasone Suppression Test I have ever come across. Cheers.

@ZeroToFinals 4 жыл бұрын

Wow, that great feedback!

@marcotayala 7 жыл бұрын

Nice vídeo, very interesting and educational. Now I understand better this system.

@Dj2anime 7 жыл бұрын

Awesome explanation! It was simple and easy to follow - I can actually wrap my head around it now :D

@funmiade575 5 жыл бұрын

I am truly enjoying these videos. Thank you so much.

@ZeroToFinals 5 жыл бұрын

Thanks again. I'm going to keep making them!

@amanchauhan7934 3 жыл бұрын

Simple, to the point and perfect

@champikasam 5 жыл бұрын

Thanks for the detailed explanation. keep up the good work!

@ZeroToFinals 5 жыл бұрын

Will do!

@deevanshirathore2730 3 жыл бұрын

Thank you so much, was super confused and now all clear mind, thank you

@Bambii348 4 жыл бұрын

Thank you, made it so easy to understand!

@reemabdelhay3497 2 ай бұрын

Amazing video.. I can’t believe that I understand it finally.. lots of love and support.. keep up the good work 🎉❤

@sameeragunasekara2785 4 жыл бұрын

Nicely & simply explained 👍thank you

@robinhall3426 6 жыл бұрын

Excellent video and explanation!

@kmysl2219 3 жыл бұрын

Perfect explanation. Thank you!

@preeshillashibchurn3847 5 жыл бұрын

Finallyy a video that helped me to understand DMST.. thank you..very helpful😊

@ZeroToFinals 5 жыл бұрын

no problem Preeshilla, glad you liked it!

@wafawiwi460 5 жыл бұрын

this was very helpful thank you

@keanutax4951 5 жыл бұрын

This is a very good and simple video, thanks!!

@ZeroToFinals 5 жыл бұрын

Thanks Keanu!

@stalinthomas8187 3 жыл бұрын

Simplified the test in a beautiful way.... Congrats

@ZeroToFinals 3 жыл бұрын

Thanks!

@kyizinthant6097 5 жыл бұрын

Thank u. You make it easier to understand. ❤️

@ZeroToFinals 5 жыл бұрын

Thanks, I'm glad to have helped

@34.muhammadhusnulhakimibin76 2 жыл бұрын

''Wah thank you, already include the summary in my slide this week for my presentation on pituitary gland pathology to my beloved students from Malaysia'' -Dr. Asawari Sant.

@muhammadyaqoob877 3 жыл бұрын

Your way of teaching is outstanding

@ZeroToFinals 3 жыл бұрын

Thank you!

@ikhlas9569 3 жыл бұрын

Thank you sooooo much!!!! very well explained!!

@lightadetoun796 11 ай бұрын

Wow! As clear as you cam ever have it!!! Brilliant 👍. Thank you very much

@abdulazizalhowaish2692 4 жыл бұрын

Thank you for the video, it's very helpful to understand the dexamethasone suppression test.

@ZeroToFinals 4 жыл бұрын

glad to help!

@ayameziane2172 2 жыл бұрын

tysm for this amazing clear explanation !!

@fatimab6064 6 жыл бұрын

Thank you great job!

@wangharry1893 5 жыл бұрын

Very helpful! 非常有幫助

@SBASAK25071996 Жыл бұрын

amazing!! understood at one go! brilliant teaching❤

@sashwattarenia258 6 жыл бұрын

excellent explanation

@Wanos-zw9sf 2 жыл бұрын

OmG thank you sooooo much I was dying with this test .. you r my hero . Thanks alot

@safayounis2762 3 ай бұрын

Awesome video, helpful and to the point! thank you

@Arpit4063 6 жыл бұрын

Very comprehensive video. 👍

@biiiaNcaXD 2 жыл бұрын

Thanks for this! Great video!

@muhammadwali203 3 жыл бұрын

Awesome explanation!

@almostawhisper1990h Жыл бұрын

Very helpful! Thank you so much ❤

@chogabykyu 3 жыл бұрын

Thank you so much for this.

@user-sw6hl1dd2x 2 жыл бұрын

I just cant really believe l understood it specially after all these years of graduation.. Really thank u so much

@dewisartika9990 3 жыл бұрын

thank you so much, so helpful!!

@m.eldadar617 7 жыл бұрын

very helpful, thanks

@ak3143 2 жыл бұрын

great explanation, thank you!!

@jediknightsharma9861 7 жыл бұрын

What effect does low dose test have on ectopic ACTH or adrenal adenoma?

@sadiasiddiqi6011 6 жыл бұрын

Great job!

@NehaShaikh21 3 жыл бұрын

Thank you so much Really couldn't get it until now

@michaelgilman4068 3 жыл бұрын

Tom, thank you. I so appreciate your instruction. Will you please explain how a high dose of Dexamethasone affects an a pituitary tumor? Why would the tumor "care"? Is it that the suppression of CRH from hypothalamus and ACTH from normal pituitary gland cells result in a net reduction.of ACTH and there a reduction in cortisol? And when you say cortisol is "reduced" does this mean less than it's initial high level but perhaps still > normal, does it mean a < normal level? Thanks again. Michael Gilman PA-C, Cape Cod. Massachusetts

@TahmidRahman 4 жыл бұрын

Really good explanation !

@hanhane0 4 жыл бұрын

thank you so much for this! really helpful

@ZeroToFinals 4 жыл бұрын

Glad to help

@reemsulaiman6796 3 жыл бұрын

this video saved my life. thank you so much

@trafficjon400 3 жыл бұрын

Steroid Dexamethisone put many in a dark place of sevier Depression. a very nice Girl on You tube is still suffering from this 4 years and suicidal. Cushings and all the symtems these horible steroids can cause.

@felipevergara4894 4 жыл бұрын

Thanks you very much, very clear your video, it help to understand very good diferents tests, cheers from Arngentina.

@wobbyyy 2 жыл бұрын

Thank you for this video!

@azahgabralla4876 6 жыл бұрын

Thank you

@jaredwainwright4621 4 жыл бұрын

what a wonderful video. this med student thanks you

@halimasaleh6870 4 жыл бұрын

thank you may god bless y'all

@betrugerzbovorni2443 3 жыл бұрын

thank you. loved it!

@natarajumididoddi5985 4 жыл бұрын

Lot clearer.big thanks

@abdoomni 6 жыл бұрын

Thanks .. made it simple

@Hichamnostik_YT 3 жыл бұрын

Love your explanation thank you ❤️

@ZeroToFinals 3 жыл бұрын

Thanks! I'm glad it helped

@GujjuDoctor 5 жыл бұрын

YOU are amazing. Thank you. Love From INDIA :)

@inaduttagupta5747 Жыл бұрын

Made me understand so well ❤

@moeyousef9006 Жыл бұрын

thanks for the video it was really helpful

@rachaelk196 4 жыл бұрын

Thanks for this upload. Very helpful

@ZeroToFinals 4 жыл бұрын

Glad to help

@lukwagonicholas1305 6 ай бұрын

Thank you Dr. Tom.

@darkmoon3646 2 жыл бұрын

Thankyou man, may god bless u!

@daliahassawi4435 7 жыл бұрын

great job, thanks!

@trafficjon400 3 жыл бұрын

Suicides are high from injecting this drug.

@mycah1993 5 ай бұрын

Thank you! You're the best!

@FaisaloOZ 6 жыл бұрын

Brilliant Mate Brilliant 👍👍👍

@reznof2011 4 жыл бұрын

What a lovely explanation

@ZeroToFinals 4 жыл бұрын

thanks johnny!

@hichembennaoum8871 5 жыл бұрын

that guy is my new superhero ! ..god bless u !

@ZeroToFinals 5 жыл бұрын

awesome!

@AnitAPescadO97 3 жыл бұрын

super clear sos un capo gracias

@williamwang9536 2 жыл бұрын

this is amazing thanks so much

@drosmanzahmil1130 2 жыл бұрын

Best explanation 😍keep it up

@alhornz 6 жыл бұрын

awesome job cheers

@muntadhralsuwela7514 6 жыл бұрын

i thought pituitary adenoma with high does of DST 8 mg it should increase ACTH and decrease cortisol

@ZeroToFinals 5 жыл бұрын

Hi Muntadhr, thanks for your comment. Giving dexamethasone will suppress ACTH in a pituitary adenoma. You are correct that with a pituitary adenoma the ACTH level will be high, however with a high dose of dexamethasone there is still enough response from the pituitary to see some suppression. Giving dexamethasone will never increase ACTH.

@sowshanmostafa3671 7 жыл бұрын

Beautiful!

@blastoff2moon429 Жыл бұрын

Really helpful thank you so much 🙏

@hayleyellenwatson7166 2 жыл бұрын

Hi, I’ve had two non suppressed and 3 suppressed tests - is that likely to be cyclical cushings?

@iamthebestyesyes 4 жыл бұрын

Thanks its really mean to me

@AhmedHassan7807 4 ай бұрын

Thank u so much. Finally, I understood it.❤❤

@ManuSidhuMD 6 жыл бұрын

Incredibly clear, informative, helpful and easy to understand - perfectly explained. Thanks very much.

@naihouyly2683 3 жыл бұрын

Thanks for your good explanation

@ZeroToFinals 3 жыл бұрын

Glad it was helpful!

@caro210309 7 жыл бұрын

GRACIAS , TOTALMENTE ENTENDIDO

@namnueng24 6 жыл бұрын

it's great. Thanks

@genevievebrunte2996 4 жыл бұрын

Can someone explain why petrosal sinus sampling would be necessary to differentiate between pituitary adenoma and ectopic when you can just use the ACTH and cortisol results from this suppression test to differentiate???