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3 Cards in this Set
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Cushing's syndrome: Dexamethasone (synthetic glucocorticoid) suppression test
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Healthy: decrease cortisol after low dose.
ACTH-producing pituitary tumor: increase cortisol after low dose; decrease cortisol after high dose. Ectopic ACTH-producing tumor (small cell carcinoma): increase cortisol after low and high dose. Cortisol-producing tumor: increase cortisol after low and high dose. |
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Cushing's syndrome
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increase cortisol due to a variety of causes.
Exogenous (iatrogenic) steroids - #1 cause; decrease ACTH. Endogenous casues: 1. Cushing's disease (70%) - due to ACTH secretion from pituitary adenoma; increase ACTH. 2. Ectopic ACTH (15%) - from nonpituitary tissue making ACTH (small cell lung cancer, bronchial carcinoids); increase ACTH. 3. Adrenal (15%) - adenoma, carcinoma, nodular adrenal hyperplasia; decrease ACTH. |
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Cushing's syndrome findings
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hypertension, weight gain, moon facies, truncal obesity, buffalo hump, hyperglycemia (insulin resistance), skin changes (thinning, striae), osteoporosis, amenorrhea, and immune suppression
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