内科学教学课件：Hypercortisolism Cushing’ syndromes.pptVIP

Adrenal CT Pituitary MRI Identification diagnosis Obesity Alcohol abuse Depressive disorder ① Pituitary Cushings syndrom Ectopic ACTH syn. adrenocortical adenoma adrenocortical carcinoma ② Diagnosis schedules Diagnosis Schedules (1) Cushing Syndrome suspected Cortisol rhythm Elevated Normal Obesity Low dose dex. test Yes No Cushing Syndrome Diagnosis Schedules (2) Cushing Syndrome ACTH rhythm Elevated suppressed ACTH-dependent Yes High dose dex. test Ectopic ACTH/CRH No Cushing Disease ACTH-independent Adrenal Tumor/Nodule Treatment Cause Treatment Cushing D Transsphenoidal surgery Ectopic ACTH Surgery+drug Adrenal Aden. Surgery Adrenal Carc. Surgery +drug Micronodular Surgery +replace Macronodular Surgery +replace 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 沈阳医学院附属二院 Hypercortisolism Cushing’ syndromes Capsula Glomerulosa Fasciculata Reticularis Medulla Aldosterone Androgen Catecholamine Adrenal Structure Cortisol Cortisol Secretion Regulation ACTH CRH Cortisol Hypothalamus Pituitary Adrenal Contents Definition Etiology Diagnose Clinical Features Hormone levels Functional test Localization Treatment Definition Cushing Syndrome A diverse symptom complex resulting from excess steroid hormone (cortisol) production Cushing Disease(mainly) A hypercortisolism resulting from pituitary ACTH hypersecretion Etiology Causes of Cushing Syndrome ACTH CRH Cortisol Hypothalamus Pituitary Adrenal Ectopic CRH syndrome Hypothalamus Cushing syn. Cushing disease (CD) Ectopic ACTH syndrome Adrenal adenoma Adrenal carcinoma Micronodular adrenal disease Massive macronodular adrenal disease Classification ACTH-dependent Cushing disease (CD) Hypothalamus syn. Ectopic ACTH syndrome ACTH-independent Adrenal adenoma A