RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022
Mental Health Nursing
Easy
A dexamethasone suppression test is used to diagnose
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022
Explanation
- The Dexamethasone Suppression Test (DST) is historically and biologically linked to the diagnosis of major depression.
- It assesses the integrity of the Hypothalamic-Pituitary-Adrenal (HPA) axis feedback system.
- A key finding in many patients with severe depression is 'non-suppression,' where cortisol levels fail to decrease after a dose of dexamethasone, indicating HPA axis hyperactivity.
- While its primary diagnostic use is for Cushing's syndrome, among the given psychiatric options, its most significant association is with depression.
Why Other Options Were Wrong
- Option A: Anxiety disorders are diagnosed based on clinical criteria from manuals like the DSM-5, focusing on symptoms of worry, fear, and physical arousal. The DST is not a diagnostic tool for anxiety.
- Option C: Mania is a state of elevated mood and energy, characteristic of bipolar disorder. Diagnosis is made through clinical observation and patient history, not with the DST.
- Option D: Schizophrenia is a complex psychotic disorder diagnosed by characteristic symptoms like delusions, hallucinations, and disorganized thought. The DST has no established role in its diagnosis.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnostic application of the Dexamethasone Suppression Test (DST) in psychiatry as background academic context rather than a clinical decision trigger.
- A nurse's role in a DST includes patient education about the test, administering the oral dexamethasone at the correct time (usually late at night), and ensuring timely collection of blood samples for cortisol measurement the next day.
- While not a routine test, an abnormal DST result can sometimes help a psychiatrist confirm a biological basis for a patient's severe depression, potentially influencing the choice towards more somatic treatments like ECT.
- Patient safety: The nurse must be aware of the patient's other medications, as drugs that affect the metabolism of dexamethasone (e.g., certain anticonvulsants) can interfere with test results.
How to Approach the Question
- First, identify the key term in the question: 'dexamethasone suppression test'. Recognize that dexamethasone is a corticosteroid.
- The question asks what this test is used to 'diagnose'. This implies you need to link the function of a corticosteroid test to a specific disease.
- Consider the options provided: Anxiety, Depression, Mania, Schizophrenia. All are psychiatric conditions.
- Recall or reason that a test involving a steroid hormone likely evaluates the endocrine system, specifically the Hypothalamic-Pituitary-Adrenal (HPA) axis and cortisol regulation.
- Connect this to your knowledge of psychopathology. The HPA axis and cortisol dysregulation are most strongly and classically associated with major depression.
- Eliminate the other options, as they are primarily diagnosed through clinical interviews and observation of behavioral and psychological symptoms, not this specific biological test.
Concept Tested & Keywords
- Concept Tested: Diagnostic application of the Dexamethasone Suppression Test (DST) in psychiatry.
- Stem keywords: dexamethasone suppression test, diagnose
- Lead-in keywords: BEST, MOST RELEVANT CLUE
Question ID
QuvPwJnFxKGVIy0N_UlDcL
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 3457-3459
E6 Pharmacology Katzung 16e p. 1108-1110
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 206-208
Practise the full RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022
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