Endocrine Exam Questions and Complete Solutions Graded A+.
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SARAH MICHELLE
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SARAH MICHELLE
How can you differentiate between Cushing and Addison disease? (in terms of secreting hormone). - Answer: Cushing: HYPERsecretion of Cortisol
"C for Cushing, C for Cortisol".
ADDison: HYPOsecretion of Cortisol & Aldosterone
"ADD - Aldosterone"
Mnemonic for Cushing - Answer: Mnemon...
,How can you differentiate between Cushing and Addison disease? (in terms of secreting hormone). -
Answer: Cushing: HYPERsecretion of Cortisol
"C for Cushing, C for Cortisol".
ADDison: HYPOsecretion of Cortisol & Aldosterone
"ADD - Aldosterone"
Mnemonic for Cushing - Answer: Mnemonic STRESSED
Skin fragile
Truncal obesity w/ small arms
Rounded face "Moon face". Reproductive- amenorrhea and ED.
Ecchymosis and Elevated BP
Stretchmark on abdominal (purple color)
Sugar extremely high (HYPERglycemia)- Polyuria & Polydipsia
Excess bodily hair in women (Hirsutism). Electrolyte imbalance: HYPOkalemia.
Dorsocervical fat pad (Buffalo hump) Depression.
Mnemonic for Addison disease - Answer: Mnemonic STEROID
Sodium and Sugar LOW: Salt craving.
Tired and muscle weakness
Electrolyte imbalance: HYPERkalemia and HYPERcalcemia.
Reproductive changes: irregular menstrual and ED
lOw BP
Increased pigmentation- Hyperpigmentation (mucus)
Diarrhea Depression.
What are causes of Cushing disease - Answer: chronic steroid therapy or tumor
What are causes of Addison disease - Answer: Immigrant: Tuberculosis
, Infection
Cancer.
Cushing disease is due to _______ secretion of __________ - Answer: excess secretion of cortisol
Addison disease is due to _______ secretion of ________ - Answer: Hyposecretion of Cortisol &
Aldosterone
A pt presents to the clinic c/o progressive weakness. Pt reports decreased libido/amenorrhea (women),
fatigue and weight gain. Vitals are significant for HTN- BP at 177/100. On Exam- you note central
obesity, moon face, atrophied limbs, purple striae on abdominal and a hump on the back of his neck.
What does this pt have?
What medication would you use to treat his BP? (Drugs/class)
What BP medication class should you avoid in this pt? Why?
How would his lab look like (electrolytes)? - Answer: Cushing
Aldosterone receptor antagonist- Spironolactone and Eplerenone.
What diagnostic tests can you order for pt with Cushing disease? What would the result indicate? -
Answer: Initial- 24hr Low-dose dexamethasone suppression test: IF cortisol >5 (high): indicates Cushing.
OR
24hr Morning Urinary Free Cortisol: If value x3 of normal= Cushing.
*IF either of the 2 tests above demonstrate HIGH cortisol -> order High Dose Dexamethasone
suppression test.
IF ACTH is suppressed by 50%, then it's d/t Cushing. Can order MRI of the brain.
IF ACTH is NOT suppressed, then it indicates lung cancer or malignancy elsewhere. Order ACTH level.
IF HIGH ACTH -> order CT of the chest to r/o lung cancer.
IF LOW ACTH -> order CT of the abdomen/pelvis.
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