Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENDOCRINE - RIA > cush > Flashcards

cush Flashcards

1
Q

where is CRH released from?

A

paraventricular nucleus of hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what stimulates ACTH release & from where?

A

CRH stimulates anterior pituitary gland to release ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

name 2 ACTH dependant causes of Cushing’s syndrome

A

1) Pituitary adenoma - Cushing’s disease

2) Ectopic ACTH release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

name 2 ACTH independant causes of Cushing’s syndrome

A

1) Therapeutic corticosteroid intake

2) Adrenal tumour (adenoma/carcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

1st line investigation suspected Cushing’s syndrome (3)

A
  • 24 hour urinary free cortisol
  • midnight cortisol
  • low dose dexamethasone suppression test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is low dose dex suppression test carried out?

A

1mg dex given at 11pm & serum cortisol measured at 8am

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

conditions that can cause high cortisol in absence of cushings?

A
  • pregnancy
  • depression
  • alcohol dependance
  • morbid obesity
  • poorly controlled DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what test helps to discriminate between pituitary source & ectopic/adrenal source of Cushing’s syndrome

A

High dose (8mg) dexamethasone suppression test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

high dose dex suppression test & pituitary source –> what is cortisol?

A

Cortisol is suppressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

high dose dex suppression test & ectopic/adrenal source –> what is cortisol?

A

no change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

clinical blood test result in cushing’s syndrome?

A

Hypernatraemia, hypokalaemia, metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Corticosteroid affect on renal tubules?

A
  • reabsorption of Na

- K+ loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

acid base imbalance seen in Cushing’s syndrome & why?

A

cellular shifts of K+ & H+ cause metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

1st line test when establishing a cause of the cushing’s syndrome?

A

Serum ACTH

9am & midnight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does a low plasma ACTH level suggest is the cause of Cushings?

A

ACTH independant cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does a non suppressed ACTH level suggest is causing Cushings?

A

ACTH dependant causes e.g. Cushing’s disease or ectopic ACTH cause

17
Q

investigation that can help to identify a microscopic pituitary adenoma

A

Petrosal sinus sampling

18
Q

low dose dex (1mg) result in cushings sydnrome

A

raised cortisol

19
Q

high dose dex (8mg) in ectopic ACTH cause of cushings sydnrome

A

high ACTH

high cortisol

20
Q

high dose dex (8mg) in Adrenal tumour

A

cortisol remains high

ACTH is low - has been suppressed

21
Q

high dose (8mg) in Cushings disease (pituitary adenoma)

A

ACTH & cortisol are suppressed

22
Q

radiological invs for pituitary adenoma

A

MRI brain

23
Q

radiological invs for ectopic ACTH production

A

Chest CT

CXR

24
Q

radiological invx for ?adrenal tumour

A

abdominal CT

25
Q

what could sudden stop in exogenous steroids precipitate?

A

Addisonian crisis

26
Q

gold standard surgery for Cushing’s disease?

A

Transspenoidal surgery

27
Q

medication offered for bridge to definitive surgical treatment

A

Metyrapone

recution of cortisol synthesis by 11B-hydroxylase inhibitoe

28
Q

mechanism of Metyrapone

A

inhibitor of 11B-hydoxylase to reduce cortisol synthesis

29
Q

what is needed following unilateral adrenectomy?

A

tapering course of exogenous steroids as their endogenous CRH & ACTH will be suppressed

30
Q

medication that simulates dopamine receptors in the brain & inhibits release of prolactin by pituitary?

A

Carbogelene

31
Q

what is Nelsons syndrome?

A

ACTH secreting tumour develops following bilateral adrenalectomy for cushing’s disease

following surgery theres a massive surge of ACTH by pituitary gland causing rapid pituirary enlargement & skin hyperpigmentation

32
Q

where does superior middle & inferior suprarenal artery arise from

A

superior - from inferior phrenic artery

middle - from abdominal aorta

inferior - from renal artery

ENDOCRINE - RIA (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions