Editing Hypercortisolism (section)

== Answers ==

# What is the role of ACTH? Where is ACTH secreted from? What stimulates release of ACTH?
#* Stimulate production of glucocorticoids and sex hormones
#* Anterior pituitary
#* CRH from the hypothalamus
# How are the causes of hypercortisolism/Cushing’s syndrome categorized? Which is the most common cause in the Western world? Which does Cushing’s disease fall under?
#* Exogenous vs. Endogenous. Endogenous classified as ACTH-dependant vs. ACTH-independent
#* Exogenous most common cause in Western world
#* Cushing’s disease is an ACTH-dependant cause
# What are clinical manifestations of hypercortisolism?
#* Central obesity, moon facies, buffalo hump, facial plethora, erectile dysfunction, decreased libido, menstrual disturbances, hirsuitism, proximal muscle weakness, easy bruisability, and abdominal striae
# What are non-adrenal urologic manifestations of hypercortisolism?
#* Hypogonadal hypogonadism (negative feedback from glucocorticoids on pituitary and hypothalamus) and urolithiasis
# What is subclinical Cushing’s syndrome?
#* Hypercortisolemia without overt clinical manifestations
# What non-radiographic tests can be used to detect Cushing’s syndrome?
#* Low-dose desamethasone suppression test
#* Late night salivary cortisol
#* 24 hour urinary cortisol
# Which form of hypercortisolism cannot be evaluated with the low-dose dexamethasone suppression test?
# After confirming hypercortisolism, how can you distinguish ACTH-dependent from ACTH-independent causes?
#* Serum ACTH
# List causes of hypercortisolism other than Cushing’s syndrome.