EN6

Question 1

list clinical features of cushing’s

Answer 1

too much cortisol
centripetal obesity
moon face and buffalo hump
proximal myopathy
hypertension and hypokalaemia
red striae
thin skin
bruising
osteoporosis 
diabetes

Question 2

what are the endogenous causes of cushing’s

Answer 2

pituitary dependent cushing’s disease
ectopic ACTH from lung cancer
adrenal adenoma secreting cortisol

Question 3

what are the investigations to determine cushing’s syndrome

Answer 3

24hr urine collection for urinary free cortisol
blood diurnal cortisol levels
then LDDST

Question 4

what would happen to the cortisol level for LDDST in cushing’s people

Answer 4

cortisol is not suppressed

Question 5

list inhibitors of steroid biosynthesis

Answer 5

metyrapone:
they inhibit 11beta-hydroxylase ==> no production of corticosterone, cortisol

Ketoconazole:
inhibit cytochrome p450 ==> no glucocorticoids, mineralocorticoids, sex steroids

Question 6

what are the surgery for cushing’s

Answer 6

trans-sphenoidal hypophysectomy

bilateral/unilateral adrenalectomy

Question 7

what’s the cause of conn’s syndrome

Answer 7

benign adrenal cortical tumour

Question 8

what are the drugs for conn’s

Answer 8

spironlactone

epleronone

Question 9

what is the cause of phaeochromocytomas

Answer 9

adrenal medulla tumours causing sudden release of catecholamines

Question 10

what is the management of paheo

Answer 10

alpha blockade ==> first therapeutic

beta blockade then for tachycardia