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11 Cards in this Set
- Front
- Back
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What is defining characteristic of Cushing's syndrome?
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Chronic excess GC
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What are the 3 causes of Cushing Syndrome? Which is considered Cushing's Dz?
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What are the 3 causes of Cushing Syndrome? Adrenal ademoma, ACTH producing pituitary adenoma (cushing's dz), ectopic ACTH producing tumor
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What signs would you find with Cushing's syndrome? (hint: NA, Water, K, BP, Neuronal)
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What signs would you find with Cushing's syndrome? ↑ NA, Water retention, ↓ K, ↑BP, Neuronal atrophy
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Why is that adrenal insufficiency is somethimes seen after the removal of an ACTH producing pituitary tumor?
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Why is that adrenal insufficiency is somethimes seen after the removal of an ACTH producing pituitary tumor? In the presence of an ACTH producing pituitary adenoma the normal pituitary cells atrophy --> adrenal insufficiency after surgical removal
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T/F ectopic ACTH producing tumor are under negative feedback control.
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FALSE
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What are common sites of ectopic ACTH producing tumors?
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What are common sites of ectopic ACTH producing tumors? Small cell lung tumors, carcinoid tumors, thymomas
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T/F adrenocortical tumors can be benign or malignant and the produce vast amounts of GCs
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T/F adrenocortical tumors can be benign or malignant (TRUE) and the produce vast amounts of GCs… FALSE- don't make GC as efficiently
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Which of the following is true: adrenal cortical carcinomas are large soft yellow-tan tumors, incidentalomas are non functioning adenomas that increase with age, Larger incidentalomas are less likely to be hormonally active.
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Which of the following is true: adrenal cortical carcinomas are large soft yellow-tan tumors-TRUE, incidentalomas are non functioning adenomas that increase with age-TRUE, Larger incidentalomas are less to be hormonally active- FALSE - MORE LIKELY
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What are two common finding in Cushing's patients?
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What are two common finding in Cushing's patients? Obesity and hypertension
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Give the algorhithm for Cushings using DEX:
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1) overnight Dex --> Suppression of urine free cortisol = neg… no suppression = positive --> Low dose dex (2 mg) --> suppression of urine free cortisol = neg… no suppression= Cushing's confirmed… next… Measure ACTH: ACTH low (ACTH independent)=image adrenals… ACTH unsupressed (ACTH dependent) --> Give HIGH dose Dex --> UFC and plasma cortisol suppressed = image pituitary (respond to high dose)... UFC and plasma unaffected --> search for ectopic ACTH tumor
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Give the alternative algorhithm for differentiating Cushing's diagnosis (pituitary vs. ectopic ACTH) using CRH stimulation:
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CRH Stimulation --> ACTH and cortisol increased= image pituitary… ACTH and Cortisol unresponsive = search for ectopic tumor
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