Adrenalcortical excess (inc. Cushings)

Answer 1

gluconeogenosis
immunosuppressive
carb, protein, lipid metabolism increased

Answer 2

sodium balance

potassium balance

Answer 3

increased sodium reabsorption

Answer 4

increased secretion of potassium

Answer 5

cortisol

androgens

Answer 6

chronic glucocorticoid secretion (loss of circadian cycle)

Answer 7

circadian (highest on waking)

Answer 8

ACTH secreting pituitary tumour adenoma

Answer 9

hyperplasia

Answer 10

Small cell lung cancers can produce ectopic ACTH

Answer 11

T

Answer 12

increased weight

Answer 13

central obesity
moon face
buffalo hump
osteoporosis

Answer 14

too much variance throughout the day

Answer 15

overnight dexamethasone test

Answer 16

binds to the glucocorticoid receptors in the posterior pituitary suppressing release of ACTH

Answer 17

50

Answer 18

50

Answer 19

48 hour dexamethasone suppression test

Answer 20

confirm the overnight dexamethasone test

Answer 21

distinguish between pituitary and other causes of Cushings

Answer 22

pituitary

Answer 23

ectopic ACTH (usually very high ACTH)

Answer 24

primary adrenal adenoma

Question 25

[cushings]: following a + dexamethasone test what investigation would be suspected if plasma ACTH is low

Answer 25

CT of the adrenal

Question 26

[cushings]: following a + dexamethasone test what cause would be suspected if: plasma ACTH is high which is responsive to HIGH dose dexamethasone.

Answer 26

posterior pituitary adenoma

Question 27

[cushings]: following a + dexamethasone test what cause would be suspected if: plasma ACTH is high but does not respond to dexamethasone

Answer 27

ectopic ACTH production (small cell lung cancer)

Question 28

[cushings]: Tx: cushings?

Answer 28

trans-sphenoidal surgery of post. pit

Question 29

[cushings]: Tx: adrenal adenoma

Answer 29

adrenalectomy

Question 30

[cushings]: Tx: ectopic?

Answer 30

surgery if localised

Question 31

[cushings]: increased skin pigmentation is only seen in very high levels of ACTH. Which cause is this a 'unique' characteristic of

Answer 31

ectopic *produces very high levels of ACTH*

Question 32

[cushings]: what is the most common cause of cushings

Answer 32

steroids (exogenous) | endogenous rare