m*********s
发帖数: 56 | 1 On Ln 12, PP 120 of MTB2, "Once the ACTH level is elevated and does NOT
suppress with high dose dexamethasone, scan the brain with an MRI". I think
the "NOT" should not be there. How do you think? | s********o
发帖数: 3319 | | l****b
发帖数: 101 | 3 好像是错的，121 写 high dose dexamethasone supresses pituitary
hypercortisolism | h*******y
发帖数: 1220 | 4 Steps are:
1. Low dose dex (sensitive but not specific) to exclude; if (-), stop; if (+
):
2. 24 h cortisol / urine (expensive but specific); if (-): look for other
reasons such as stress...; if (+):
3. High dose dex:
positive: adrenal or puituitary adenoma
--high ACTH = pituitary = MRI;
--low ACTH = adenoma of adrenal gland;
Negative high dose = small cell carcinoma (high ACTH) or adrenal Ca (low
ACTH). | h*******y
发帖数: 1220 | 5 CT of the chest or adrenal gland should be the answer. | f*****y
发帖数: 464 | 6 同意楼主。而且这句话本身就说得不对，明明是cortisol被suppressed,怎么变成ACTH
被suppressed了？
查了一下老版MTB，是没有这半句话的。
think
【在 m*********s 的大作中提到】
: On Ln 12, PP 120 of MTB2, "Once the ACTH level is elevated and does NOT
: suppress with high dose dexamethasone, scan the brain with an MRI". I think
: the "NOT" should not be there. How do you think?
|
|
