Podcast
Questions and Answers
Πόση είναι η τιμή του β όταν α = 3 και γ = 5;
Πόση είναι η τιμή του β όταν α = 3 και γ = 5;
Ποια είναι η σχέση μεταξύ των α, β και γ;
Ποια είναι η σχέση μεταξύ των α, β και γ;
Πόσοι είναι οι τρόποι να λύσουμε το σύστημα των εξισώσεων;
Πόσοι είναι οι τρόποι να λύσουμε το σύστημα των εξισώσεων;
Πώς μπορούν να σχετιστούν οι τιμές των α, β και γ;
Πώς μπορούν να σχετιστούν οι τιμές των α, β και γ;
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Πόσο το σύστημα των εξισώσεων επηρεάζεται από τη μεταβολή ενός από τα στοιχεία;
Πόσο το σύστημα των εξισώσεων επηρεάζεται από τη μεταβολή ενός από τα στοιχεία;
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What is the primary cause of ACTH-dependent Cushing syndrome?
What is the primary cause of ACTH-dependent Cushing syndrome?
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What is the most common clinical finding in Cushing syndrome?
What is the most common clinical finding in Cushing syndrome?
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What is the term for excessive ACTH production resulting from an endocrine or nonendocrine tumor?
What is the term for excessive ACTH production resulting from an endocrine or nonendocrine tumor?
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Which of the following is a characteristic feature of Cushing syndrome?
Which of the following is a characteristic feature of Cushing syndrome?
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What is the term for adrenal gland hypofunction associated with primary adrenal insufficiency?
What is the term for adrenal gland hypofunction associated with primary adrenal insufficiency?
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What is the cause of ACTH-independent Cushing syndrome in most cases?
What is the cause of ACTH-independent Cushing syndrome in most cases?
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What is the result of supraphysiologic glucocorticoid concentrations in the body?
What is the result of supraphysiologic glucocorticoid concentrations in the body?
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What is the percentage of ACTH-dependent Cushing syndrome cases caused by pituitary adenomas?
What is the percentage of ACTH-dependent Cushing syndrome cases caused by pituitary adenomas?
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What is the treatment of choice for adrenal carcinoma?
What is the treatment of choice for adrenal carcinoma?
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What is the usual dose range for ketoconazole in the treatment of Cushing syndrome?
What is the usual dose range for ketoconazole in the treatment of Cushing syndrome?
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Which of the following medications is not commonly used in the treatment of ectopic ACTH syndrome?
Which of the following medications is not commonly used in the treatment of ectopic ACTH syndrome?
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What is the maximum dose of metyrapone that can be used in the treatment of Cushing syndrome?
What is the maximum dose of metyrapone that can be used in the treatment of Cushing syndrome?
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What is the initial dose of mitotane used in the treatment of pituitary-dependent Cushing syndrome?
What is the initial dose of mitotane used in the treatment of pituitary-dependent Cushing syndrome?
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Which of the following is not a non-pharmacologic therapy for Cushing syndrome?
Which of the following is not a non-pharmacologic therapy for Cushing syndrome?
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What is the dose range for pasireotide in the treatment of Cushing syndrome?
What is the dose range for pasireotide in the treatment of Cushing syndrome?
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What is the maximum dose of ketoconazole that can be used in the treatment of Cushing syndrome?
What is the maximum dose of ketoconazole that can be used in the treatment of Cushing syndrome?
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What is a rare cause of primary hyperaldosteronism?
What is a rare cause of primary hyperaldosteronism?
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What is a side effect of mifepristone?
What is a side effect of mifepristone?
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What is the name of the glucocorticoid receptor antagonist that inhibits dexamethasone suppression?
What is the name of the glucocorticoid receptor antagonist that inhibits dexamethasone suppression?
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What is essential to identify adrenal insufficiency in patients with Cushing syndrome?
What is essential to identify adrenal insufficiency in patients with Cushing syndrome?
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What is the FDA-approved treatment for endogenous Cushing syndrome?
What is the FDA-approved treatment for endogenous Cushing syndrome?
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What is the name of the disease caused by aldosterone producing adenoma?
What is the name of the disease caused by aldosterone producing adenoma?
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What is a common adverse effect of mifepristone?
What is a common adverse effect of mifepristone?
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What is categorized as either primary or secondary?
What is categorized as either primary or secondary?
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What is the primary goal of treating hypercortisolism?
What is the primary goal of treating hypercortisolism?
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What percentage of patients with hypercortisolism develop Cushing-induced osteoporosis?
What percentage of patients with hypercortisolism develop Cushing-induced osteoporosis?
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What is the purpose of the low-dose dexamethasone suppression test (DST)?
What is the purpose of the low-dose dexamethasone suppression test (DST)?
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Which of the following tests is used to determine the etiology of hypercortisolism?
Which of the following tests is used to determine the etiology of hypercortisolism?
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What is the purpose of adrenal vein catheterization?
What is the purpose of adrenal vein catheterization?
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What is the significance of facial plethora in patients with hypercortisolism?
What is the significance of facial plethora in patients with hypercortisolism?
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What is the purpose of metyrapone stimulation test?
What is the purpose of metyrapone stimulation test?
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What is the role of high-resolution CT scanning or MRI in adrenal gland surgery?
What is the role of high-resolution CT scanning or MRI in adrenal gland surgery?
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What is the treatment of choice for Cushing disease?
What is the treatment of choice for Cushing disease?
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When is radiotherapy preferred for tumors?
When is radiotherapy preferred for tumors?
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What is the benefit of laparoscopic adrenalectomy?
What is the benefit of laparoscopic adrenalectomy?
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What is the primary use of pharmacotherapy in Cushing disease?
What is the primary use of pharmacotherapy in Cushing disease?
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What is the effect of metyrapone on cortisol synthesis?
What is the effect of metyrapone on cortisol synthesis?
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What is a common side effect of metyrapone administration?
What is a common side effect of metyrapone administration?
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What is the effect of ketoconazole on cortisol levels?
What is the effect of ketoconazole on cortisol levels?
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What is a potential adverse effect of ketoconazole?
What is a potential adverse effect of ketoconazole?
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Study Notes
Σύνοψη
- Το κείμενο αποτελείται από 11 pages με διάφορες σημειώσεις και σύμβολα.
Σύμβολα και Έννοιες
- Το σύμβολο ∼ χρησιμοποιείται για να υποδηλώσει ένα μαθηματικό σύμβολο.
- Οι γράμματες α και β χρησιμοποιούνται ως μαθηματικές Variables.
- Το γράμμα γ χρησιμοποιείται ως ένα άλλο μαθηματικό σύμβολο.
- Τα σύμβολα ✔️ χρησιμοποιούνται για να υποδηλώσουν έγκριση ή ορθότητα.
- Το σύμβολο ≥ χρησιμοποιείται για να υποδηλώσει μια μαθηματική σχέση.
Παθοφυσιολογία της Νόσου Cushing
- Η ノ ー Σο Cushing οφείλεται σε υπερπαραγωγή κορτιζόλης από τους αδένες του αδρήνα (ACTH-εξαρτώμενη) ή από ανωμαalous αδρενοκορτιχαλές ιστίδες (ACTH-ανεξάρτητες)
- Η ACTH-εξαρτώμενη Νόσος Cushing (80% των περιπτώσεων) οφείλεται συνήθως στη υπερπαραγωγή ACTH από την υπόφυση, προκαλώντας διμερή υπερπλασία των αδένων του αδρήνα
- Λιγότερες περιπτώσεις οφείλονται σε έκτοπη παραγωγή ACTH από όγκους της πνεύμονος, του πankreas ή του θυρεοειδούς
Κλινική Εικόνα
- Τα πιο συνηθισμένα συμπτώματα είναι η κεντρική οβειδότητα και η όψη του προσώπου (90% των ασθενών)
- Άλλα συμπτώματα μπορεί να περιλαμβάνουν περιφερική οβειδότητα, συσσώρευση λίπους στο δέρμα του τραχήλου και των ώμων (bufallo hump), και όψη του προσώπου όπως του μηνός (moon facies)
Θεραπεία
- Η θεραπεία πρώτης γραμμής είναι η χειρουργική αντιμετώπιση του όγκου της υπόφυσης ή των αδένων του αδρήνα
- Η φαρμακευτική θεραπεία χρησιμοποιείται ως δεύτερη γραμμή θεραπείας σε ασθενείς που δεν είναι καλά υποψήφιοι για χειρουργική επέμβαση
Φαρμακευτική Θεραπεία
- Οι φαρμακευτικές ουσίες που χρησιμοποιούνται για τη θεραπεία της Νόσου Cushing περιλαμβάνουν τη μετυραπόνη, τη κετοكونαζόλη, τη міfepristone, και τη_pasireotide
- Η μετυραπόνη bloqueira την 11 β-υδροξυλάση, που επηρεάζει τη σύνθεση της κορτιζόλης
- Η κετοκονนาζόλη inhibits τις κυτοχρώμες P 450, συμπεριλαμβανομένης της 11 β-υδροξυλάσης και της 17 α-υδροξυλάσης
Υπεραλδοστερονισμός
- Ο υπεραλδοστερονισμός οφείλεται σε υπερπαραγωγή της αλδοστερόνης και μπορεί να κατηγοριοποιηθεί ως πρωτοπαθής ή δευτεροπαθής
- Η πρωτοπαθής υπεραλδοστερονισμός (PA) οφείλεται συνήθως σε διμερή υπερπλασία των αδένων του αδρήνα και αλδοστερόνη-παραγόμενη αδενωμα (Conn σύνδρομο)
Διάγνωση
- Η διάγνωση της υπερκορτιζολισμού μπορεί να επιτευχθεί με ένα ή περισσότερα από τα ακόλουθα τεστ: 24 ωρο尿_ic cortisol (UFC), μεσάνυχτα πλάσμα κορτιζόλης, 晚-night (11 PM) σιαλικό cortisol, και/ή χαμηλής δόσης δεξαμεθαζώνης καταστολής τεστ (DST)
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Description
Δοκιμασία μαθηματικών κατανομών και στατιστικών εννοίων.
