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Module CC-07 · Version 1.0

Adrenal and Pituitary Laboratory Assessment

Cortisol, ACTH, prolactin, and growth hormone/IGF-1 results require timing and context. Interpret cortisol against its circadian pattern; pair ACTH with same-draw cortisol and its own preanalytical path; distinguish the questions posed by stimulation and suppression testing; and account for medication, illness, and assay factors that can turn a technically valid result into a misleading one.

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Who this module is for

Clinical laboratory scientists and trainees who report or review adrenal and pituitary hormone results, including staff who collect, handle, or troubleshoot basal and dynamic endocrine testing specimens.

Learning objectives

  • Explain why cortisol and several pituitary hormones cannot be interpreted without timing and context
  • Distinguish screening, stimulation, and suppression-test purposes
  • Recognize preanalytical, medication, and assay factors that can invalidate or complicate results

How completion works

Mark every required section done and answer every knowledge check in those sections correctly. The final save completes the module automatically.

Sources

8 sources

  1. 1. Bornstein SR, Allolio B, Arlt W, et al. Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(2):364-389.

    Source note · professional society guidance

  2. 2. Nieman LK, Biller BM, Findling JW, et al. The Diagnosis of Cushing's Syndrome: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008;93(5):1526-1540.

    Source note · professional society guidance

  3. 3. CLSI. Handling, Transport, Processing, and Storage of Blood Specimens for Routine Laboratory Examinations. 1st ed. CLSI document PRE04. Clifton Park, PA: Clinical and Laboratory Standards Institute; 2023.

    Source note · consensus standard

  4. 4. Code of Federal Regulations, Title 42, Part 493, Subpart K, Section 493.1253, Establishment and verification of performance specifications.

    Source note · federal regulation

  5. 5. National Center for Biotechnology Information Bookshelf (Endotext). Adrenal Insufficiency. https://www.ncbi.nlm.nih.gov/books/NBK279083/

    Source note · peer-reviewed literature

  6. 6. Casanueva FF, Molitch ME, Schlechte JA, et al. Diagnosis and Treatment of Hyperprolactinemia: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(2):273-288.

    Source note · professional society guidance

  7. 7. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML. Evaluation and Treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(6):1587-1609.

    Source note · professional society guidance

  8. 8. Stokes FJ, Bailey LM, Ganguli A, Davison AS. Assessment of endogenous, oral and inhaled steroid cross-reactivity in the Roche cortisol immunoassay. Ann Clin Biochem. 2014;51(Pt 4):503-507.

    Source note · peer-reviewed original research