Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which diagnostic test is primarily used to confirm Addison's disease?

TSH test
Synacthen test
ACTH stimulation test
Cortisol level test

The correct answer is: Synacthen test

The Synacthen test, also known as the ACTH stimulation test, is the primary diagnostic test to confirm Addison's disease. This test evaluates the adrenal glands' response to adrenocorticotropic hormone (ACTH), which is responsible for stimulating cortisol production. In Addison's disease, the adrenal glands are damaged or not functioning properly, leading to insufficient cortisol release. During the Synacthen test, synthetic ACTH (Synacthen) is administered, and subsequent cortisol levels are measured. If there is little to no increase in cortisol levels following stimulation, it indicates adrenal insufficiency, confirming Addison's disease. While the cortisol level test is important for assessing adrenal function, it is not specific enough to confirm Addison’s disease on its own. Low cortisol levels can also appear in other conditions. TSH tests assess thyroid function and are not related to adrenal diseases, whereas the ACTH stimulation test specifically measures the adrenal gland's response to ACTH, thus making the Synacthen test the preferred diagnostic tool for Addison’s disease confirmation.