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OasisLMS
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EndoBytes: Patient-Centered Approach to Hypercorti ...
Screening and Diagnostic Approach
Screening and Diagnostic Approach
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Video Transcription
Video Summary
This module covers the screening and diagnosis of hyperfunction of the hypothalamic-pituitary-adrenal axis, including Cushing syndrome and mild autonomous cortisol secretion (MACS). Recognition relies on clinical history, examination, and targeted biochemical tests like late-night salivary cortisol, 24-hour urinary-free cortisol, and dexamethasone suppression tests, requiring confirmation by multiple abnormal results. Differential diagnosis distinguishes true Cushing from pseudocushing states, followed by classification into ACTH-dependent or independent disease. Imaging and inferior petrosal sinus sampling assist in localizing lesions. The stepwise algorithm ensures accurate diagnosis, reduces misclassification, and guides personalized treatment, addressing cardiometabolic and skeletal risks.
Keywords
hypothalamic-pituitary-adrenal axis
Cushing syndrome
mild autonomous cortisol secretion
diagnostic tests
ACTH-dependent disease
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