Cushings syndrome Endocrine Society
1. Which of the following is recommended by the Endocrine Society as the first step in testing for Cushing's syndrome?
2. Which patient group is recommended for testing for Cushing's syndrome?
3. What are the recommended initial tests for Cushing's syndrome?
4. What is the purpose of the 1-mg overnight DST in the initial testing of Cushing's syndrome?
5. Which of the following tests is recommended for children with decreasing height percentile and increasing weight?
6. What is the recommended method of testing for Cushing's syndrome in patients suspected of having cyclic Cushing's syndrome?
7. What is the main cause of mortality in individuals with severe hypercortisolism, according to early reports?
8. What is the standard mortality ratio (SMR) after successful normalization of cortisol?
9. What are the potential consequences of successful treatment of hypercortisolism in Cushing's syndrome?
10. What are the diagnostic criteria that suggest Cushing's syndrome?
11. What is the Endocrine Society's recommendation regarding the use of random serum cortisol or plasma ACTH levels for testing Cushing's syndrome?
12. What is the Endocrine Society's suggestion for the evaluation of individuals with normal test results in whom the pretest probability is high for Cushing's syndrome?
13. In what situation does the Endocrine Society recommend the use of the 1-mg overnight DST rather than UFC for initial testing for Cushing's syndrome?
14. What is the Endocrine Society's recommendation for the use of dexamethasone testing in the initial evaluation of pregnant women?
15. What test should be used in the initial evaluation of pregnant women suspected of having Cushing's syndrome?
16. What should be done for patients with normal test results in whom the pretest probability is high?
17. What are the diagnostic criteria that suggest Cushing's syndrome?
18. What is the most common cause of Cushing's syndrome?
19. What are some features of Cushing's syndrome that are more discriminatory than others?
A) Obesity, depression, diabetes, hypertension, or menstrual irregularity
B) Reddish purple striae, plethora, proximal muscle weakness, bruising with no obvious trauma, and unexplained osteoporosis
C) Physical stress, malnutrition, anorexia nervosa, intense chronic exercise, and hypothalamic amenorrhea
D) None of the above
20. What is the rationale for early recognition and treatment of mild Cushing's syndrome?
21. What is the likely cause of mild hypercortisolism associated with certain psychiatric disorders, poorly controlled diabetes mellitus, and alcoholism?
22. What do the recommendations for testing for Cushing's syndrome in these guidelines primarily rely on?
23. Which of the following is the most common cause of Cushing's syndrome?
24. Which of the following is NOT a discriminatory feature of Cushing's syndrome?
25. What is the sensitivity of combined reduced linear growth and increased weight in children for the diagnosis of Cushing's syndrome?
26. Which of the following is the most appropriate initial test for the diagnosis of Cushing's syndrome?
27. What is the recommended approach to individuals with normal test results but a high pretest probability of Cushing's syndrome?
28. Which of the following drugs accelerates dexamethasone metabolism by induction of CYP 3A4?
29. What is the recommended time frame for withdrawing estrogen-containing drugs before testing or retesting for Cushing's syndrome?
30. What is the advantage of obtaining at least two measurements of urine or salivary cortisol for the diagnosis of Cushing's syndrome?
31. Which of the following drugs inhibits dexamethasone metabolism by inhibition of CYP 3A4?
32. What does UFC measure in the evaluation of cortisol secretion?
33. Which of the following drugs increases CBG and may falsely elevate cortisol results?
34. What is the first morning void?
35. What should patients avoid during the UFC collection?
36. When is the best time to collect a late-night salivary cortisol sample?
37. What is the best technique for collecting saliva for late-night salivary cortisol testing?
38. Which medical condition may cause overactivation of the HPA axis without true Cushing's syndrome?
39. What is the cutoff value for suppression of serum cortisol in the 1-mg overnight dexamethasone suppression test?
40. What is the recommended dexamethasone dose for the 48-h low-dose dexamethasone suppression test?
41. What is the recommended length of abstinence from alcohol before performing the 48-h, 2 mg/d low-dose dexamethasone suppression test?
42. How many collections of 24-h urine should be performed for the UFC test?
43. At what time should saliva samples be collected for the late-night salivary cortisol test?
44. What is the most validated assay used in the United States to measure salivary cortisol?
45. What is the cutoff value for the suppression of serum cortisol in the 1-mg dexamethasone suppression test?
46. What is the recommended duration of abstinence from alcohol before performing the 48-h, 2 mg/d low-dose dexamethasone suppression test?
47. What is the diagnostic accuracy of the 48-h, 2 mg/d low-dose dexamethasone suppression test in adults without Cushing's syndrome?
48. Which of the following tests is recommended for retesting patients with initially normal test results who develop new or progressive signs or symptoms of Cushing's syndrome?
49. Why is the diagnostic accuracy of tests previously advocated for the diagnosis of Cushing's syndrome considered too low to recommend them for testing?
50. Why is referral to endocrinology centers with expertise and interest in Cushing's syndrome recommended for patients with abnormal initial testing?
51. Which of the following tests is recommended for subsequent evaluation of abnormal test results from one of the high-sensitivity tests?
52. What is the basis of the midnight serum cortisol test?
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