3 Questions
Which of the following can cause Pseudo-Cushing's syndrome?
Alcohol abuse, severe depression, eating disorders, and chronic illness
Which test is used to differentiate between true and pseudo-Cushing's states?
Insulin tolerance test
Why is ITT not a first-line diagnostic test for Cushing's syndrome?
It has potential risks
Study Notes
- Pseudo-Cushing's syndrome can be caused by alcohol abuse, severe depression, eating disorders, and chronic illness.
- It presents with similar clinical and biochemical features as true Cushing's syndrome.
- The insulin tolerance test (ITT) can differentiate between true and pseudo-Cushing's states.
- ITT involves administering intravenous insulin to induce hypoglycemia and stimulate cortisol release.
- In true Cushing's syndrome, there will be a blunted or absent cortisol response due to excess cortisol feedback on the HPA axis.
- In pseudo-Cushing's states, the HPA axis can respond to stress, and the ITT would generally show an appropriate cortisol response.
- ITT is not a first-line diagnostic test for Cushing's syndrome due to potential risks.
- Alternative tests, such as dexamethasone suppression test, urinary free cortisol, or salivary cortisol measurements, are performed before considering ITT.
- ITT is reserved for cases where other tests are inconclusive.
- Differentiating true and pseudo-Cushing's states is important for appropriate treatment.
Think you know the differences between true and pseudo-Cushing's syndrome? Test your knowledge with this quiz! Learn about the various causes and clinical features of pseudo-Cushing's, as well as the insulin tolerance test (ITT) used to differentiate it from true Cushing's. Discover why ITT is not a first-line diagnostic test and what alternative tests are used. With this quiz, you'll gain a better understanding of the importance of distinguishing between true and pseudo-Cushing's for effective treatment.
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