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How can you differentiate between pituitary and ectopic causes of Cushing's Syndrome using the high-dose dexamethasone test?
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Suppression of cortisol after high-dose dexamethasone indicates a pituitary origin, while no suppression suggests an ectopic origin
What treatment options are available for patients with Cushing's Syndrome caused by a pituitary tumor?
Transsphenoidal surgery, radiation therapy, and adjusting steroid use if due to prolonged steroid treatment
What hormone does the hypothalamus release that initiates the production of corticosteroids?
Corticotropin-releasing hormone (CRH)
What is Addison's crisis?
A severe form of Addison's disease where there is a critical deficit of cortisol and aldosterone, leading to potential cardiovascular collapse
List two critical features of the pathophysiology of Addison's Disease.
Decreased cortisol levels leading to stress intolerance and decreased aldosterone levels resulting in sodium and fluid loss, and cardiovascular risks
What are common causes of Cushing's Syndrome?
Adrenal cortex adenomas, pituitary tumors, ectopic ACTH production from tumors, and prolonged steroid use
How is the 24-hour Urine Free Cortisol Test used in diagnosing Cushing's Syndrome?
It measures cortisol levels over a day to determine if they are elevated, which can indicate Cushing's Syndrome
Name the primary hormones produced by the adrenal cortex.
Cortisol, aldosterone, and androgens (sex hormones)
Which gland releases Adrenocorticotropic hormone (ACTH)?
The pituitary gland
What emergency treatment is provided for Addison's Disease?
Steroid replacement with glucocorticoids and fluid volume replacement with normal saline or normal saline with 5% dextrose
What characterizes Cushing's Syndrome?
Excessive corticosteroid production (hypercortisolism)
What physical features are indicative of Cushing's Syndrome?
Moon face, buffalo hump, truncal obesity, abdominal striae, and muscle weakness
What are the primary causes of Addison's Disease?
Damage to the adrenal cortex due to autoimmune diseases, cancer, trauma, sepsis, or drugs
Which diagnostic test confirms adrenal insufficiency in Addison's Disease?
Cosyntropin Stimulation Test
What are the primary differences in appearance between patients with Addison's Disease and Cushing's Syndrome?
Patients with Addison's Disease often appear thin and weak, while those with Cushing's Syndrome can appear hypertensive, obese, and potentially hirsute
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