Chapter 96

Question 1

Dose and duration ____
Clinical signs and symptoms of Cushing syndrome often develop in patients treated with exogenous steroids at
doses equivalent to_______

Answer 1

20 mg of prednisone daily for more than 1 month

Question 2

electrocardiographic changes in Cushing syndrome

Answer 2

Decreased PR interval

duration of the PR interval appears to correlate inversely with adrenal cortisol production rates

Question 3

Cardiac effects of Cushing syndrome:

Answer 3

cardiac remodeling and
fibrosis, ventricular remodeling, and an impairment of relaxation

Question 4

ECG abnormalities in acromegaly

Answer 4

left- axis deviation, septal Q waves, ST- T wave depression, abnormal QT dispersion, and conduction system defects, develop in up to 50% of patients with acromegaly

dysrhythmias: atrial and ventricular ectopic beats, sick sinus syndrome, and supraventricular and ventricular tachycardia. Monitoring shows a 4x increase in complex ventricular arrhythmias

Question 5

Acromegalic cardiomyopathy

Answer 5

concentric biventricular hypertrophy,
diastolic dysfunction, and mitral and aortic valve disease, and can
occur even in the absence of cardiovascular risk factors

Question 6

3 phases of acromegalic cardiomyopathy

Answer 6

1. young patients with new onset acromegaly and involves a hyperkinetic syndrome with increased myocardial contractility and enhanced cardiac output
2. More evident hypertrophy with impaired diastolic filling and reduced cardiac performance during exercise
3. Impaired systolic function and progressive low cardiac
   output

Question 8

Comorbidities in acromegaly

Answer 8

Hypertension, type 2 diabetes, and hyperlipidemia (hypertriglyceridemia and reduced high- density lipoprotein (HDL)