Pt with +ve constitutional symptoms and cough, has buffalo hump and signs of increased ACTH, x-ray showed mass in the lung, what is the most likely diagnosis?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة: B. Small cell lung cancer (ectopic ACTH)
Constitutional symptoms + cough + a lung mass + Cushingoid features with high ACTH = ectopic ACTH syndrome from small cell lung carcinoma, the classic paraneoplastic cause of Cushing's.
- Squamous cell carcinoma (A) is the classic cause of paraneoplastic hypercalcemia (PTHrP), not Cushing's.
- Pituitary adenoma (C) would not explain the lung mass; adrenal adenoma (D) and exogenous steroids (E) give suppressed ACTH.
ليش كل خيار صح أو غلط
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A
ليش غلط
Squamous cell carcinoma is typically linked to hypercalcemia (PTH-like hormone), not Cushing syndrome; ectopic ACTH is the small cell association.
✓ Step Up To Medicine 6th Edition 2024 (Lung nodules).pdf · p. 3 -
B
ليش صح
Cushing syndrome from ectopic ACTH secretion is typically associated with small cell lung carcinoma, fitting the lung mass, constitutional symptoms and raised ACTH.
✓ Step Up To Medicine 6th Edition 2024 (Lung nodules).pdf · p. 3 -
C
ليش غلط
Cushing disease is a pituitary adenoma making ACTH; ectopic ACTH syndrome is a non-pituitary tumour such as small cell lung carcinoma, which matches the lung mass.
✓ Adrenal summary.pdf · p. 1 -
D
ليش غلط
Adrenal adenomas make cortisol on their own and are ACTH-independent, so they do not explain the signs of increased ACTH.
✓ Adrenal summary.pdf · p. 1 -
E
ليش غلط
High-dose glucocorticoids decrease ACTH secretion (by lowering hypothalamic CRH), so exogenous steroid use does not give raised ACTH.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10
- المصدر
- Step Up To Medicine 6th Edition 2024 (Lung nodules).pdf · p. 3
Adrenal summary.pdf · p. 1 - المحاضرة
- Cushing's Syndrome · Endocrinology · Module B
- ظهر في
- Endo bank · Respi bank