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Old 04-13-2015
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Default Cushings Syndrome

I think I'm losing it now.

Kaplan says Cushings disease vs Ectopic ACTH production, there would be hyperpigmentation in the ectopic but not the disease because a pituitary adenoma wouldn't make enough ACTH to cause it.

But than I was checking on step up to USMLE step 1 (Done by the founder of DIT, Brian Jenkins and a resource that was used throughout the DIT course) and that says the opposite. That there would be pigmentation in the disease but not for any other reasons.

I'm not entirely sure what source I should go by. Does anyone have any idea with explanation. I just can't seem to let this go.

Step Up 2014 edition page 189.

Kaplan Physio 2015 page 290.

Maybe I just can't read or something so I put reference pages for both books. You can google them both online without having to download them.

Thanks!
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Old 04-13-2015
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Default

Quote:
Originally Posted by mintyf View Post
I think I'm losing it now.

Kaplan says Cushings disease vs Ectopic ACTH production, there would be hyperpigmentation in the ectopic but not the disease because a pituitary adenoma wouldn't make enough ACTH to cause it.

But than I was checking on step up to USMLE step 1 (Done by the founder of DIT, Brian Jenkins and a resource that was used throughout the DIT course) and that says the opposite. That there would be pigmentation in the disease but not for any other reasons.

I'm not entirely sure what source I should go by. Does anyone have any idea with explanation. I just can't seem to let this go.

Step Up 2014 edition page 189.

Kaplan Physio 2015 page 290.

Maybe I just can't read or something so I put reference pages for both books. You can google them both online without having to download them.

Thanks!

yes thats correct. Ectopic would make a lot more ACTH from the precursor POMC and hence more MSH and more likely cause pigmentation than a pituitary adenoma causisng ACTH secretion.

Also this is the reason why a high dose dexamethasone suppression test will "supress" the pit adenoma secretion of acth but not the ectopic. And thats how u differentiate them.
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