I watch at 3x speed when reviewing, using script editor in chrome: • Ctrl+shift+j • $('video').playbackRate=3 • Enter (It can go in decimals, even up to 16x)
Your videos are the best! Your videos deserve a ton of love from everyone viewing them...I always get a ton of value from your Vids! Thank you, thank you!
I like the new videos more showing the manifestation of the clinical signs in real life it s really cool and the approch to diagnosis and i hope that u make some videos about gyneco clinical medicine
Very good video, I have cushing disease cause by a pit adenoma, my red flag was not getting my menstrual cycle/having issues getting pregnant, also have a cushing body, had surgery on 2018 that fail, now not cadidate to have surgery, just did radiation and taking levoketoconazole to lower my cortisol levels
Hello I was finally diagnosed with Cushing disease in 2006 after years of going to different doctors and being mis diagnosed I had a tumor on my pituitary had surgery and within a year the tumor came back no doctor in my state wanted to do a second surgery because the tumor was close to my optic nerve my doctor found Dr.Kelly in California that specialized in tumors in 2008 I was in surgery for 10 hours because of the amount of scar tissue but he got the tumor out through my nose I have to take prednisone for the rest of my life and thyroid medicine
@LK-fy4dd I had the transphenoidal surgery and symptoms continue. Some days are worse than others. I'm trying to find an endo who can really help me. My last one moved to NYC and was good.
Hirtuism is just a small amount of hair directly under the ear, along the peterigoids which is the 'jawline'. Bone lengthening in this area is typically the result of genetic hormone imbalances and changes (diapause for example), including congenital deafness, ASD, etc. The bone lengthening in this area is what can give the masculine appearance. Even with the downy hair the appearence is still typically feminine with increased fat around the lower abdomen and hips.
Once my doctor saw the elevated blood pressure, with the extended stomach, with the buffalo hump, with the scalp acne, with the loss of emotional control, the incredible weight gain, it should have been a clue.
@@naturelovers6987 Thanks, no. I went in for my annual physical and he did not look at anything or touch anything. He sat on his stool and told me I didn't have Cushings. Without examining me. So no,he is not my doctor anymore.
Could years of chronic, terrorizing stress (a constant state of fight or flight) cause Cushing's? I'm talking domestic violence...I am 99.9% sure I have Cushing's (all symptoms). Getting tested next week.
Hlo please share about your reports because i was also in chronic stress after that i got all Cushing symptoms I don't what to do please share your regarding this 😢😢😢
Question: If the suspected cause of Cushing Disease is a pituitary adenoma, wouldn't the high dose dexamethasone test suppress only the cortisol and the levels of ACTH would remain high? Cramming for my PANCE right now. Take it in 3 weeks. These videos are saving my life!!!
Actually u did a really good question. First, you have to remember that almost all patients with Cushings disease have *micro*adenoma that have a really good response to CRH test and corticosteroids suppression test. However, some *macro*adenomas isn’t able to response adequately to these test. Because, they have almost more impact in hormones than the rest of the pituitary gland, different from the microadenomas ones.
I have several of these symptoms including fatty hump between shoulders, significant trunk fat, uncontrolled hypertension despite 2 hypertensive meds, round face, adult acne in my 60's and osteoporosis with history of severe T9 compression fracture and other minor compression fractures, but I have not yet had any cortisol tests or the dexamethasone test. I have had two PET scans due to having smoldering multiple myeloma which did not reveal either pituitary or adrenal gland tumors. However, I do have a parotid adenoma and a suspected adenoma on the right dome of the hemidiaphragm. I am wondering if either of these could cause Cushing's Syndrome? If not, then I suspect I may have Cushing's Syndrome from years of inhaled corticosteroids for my asthma as well as 8 months of prednisone for polymyalgia rheumatica and occasional prednisone for chronic bronchitis and a few bouts of pneumonia. I would really like to be able to ask my PCP intelligent questions about getting more testing, so I'd appreciate any insights.
Loved the video! I was diagnosed with PCOS & insulin resistance from my obgyn but my rheumatologist agreed it would also be a good idea to see an endocrinologist to check for Cushings when I asked if I could have both. My Corozal level is high but I don't have a huge hump on my back and I have thick wrists and ankles, overweight, diabetes... face is round/wide but I am not sure if it's as "moon face" as your example. I had Tinea incognito for over 10 years (fungal infection that was made worse by steroids being prescribed to treat the rash and they kept giving me steroids for years on and off until i finally found a good dermatologist that figured it out)... I also suffered from MRSA outbreaks for years (but only when my immune system was compromised due to the Tinea incognito), very weak immune system (flu would land me in the hospita every year turning into Pneumonia or other long term respiratory issue), chronic inflammation and muscle weakness/ pain. I am also unable to get pregnant and my doctor said that even if we did successfully conceive, it would probably be too high-risk to carry the baby to full term. I just keep wondering... could it be Cushings even if I don't have the big physical "identifiers" for it? At this point- I honestly hope it is Cushings just to get some answers. I have a new patient appointment with an endocrinologist and I can only hope they are as well informed as you! 🤞🤞🤞🤞🤞🤞. ♡
Wow! It’s amazing. Any of us are alive. What type of doctor do you recommend to diagnose Cushings syndrome/disease? hi I’m an anal cancer survivor and I just had my annual CT scan. It came back with minimal uptake in the anal canal, but I have a hump on my back and I have suffered from chronic stress. Heart palpitations/sweating.. I prefer to find a natropath.
I have pituitary and adrenal adenomas. I cannot get the VA to do anything related to cushings. They just keep telling me they are watching the tumors. My quality of life is going down fast. They won’t take the tumors out, and blood work comes back with 4 items high (ADH, cortisol, TSH, B12) and 3 items low (Imm gran#, eosin#, baso#) What can I ask them to do so that the Endo will accept its cushings? She just says I’m weird and won’t consider cushings. But I can tell something is wrong with my body. And it’s been 8 years….
Prayers for you - 8 years is TOO long! Can you get a different endo.? Even endos expect very overt symptoms, as listed in this vid. And Cushie's suffer greatly especially when they have mild or cyclic Cushing's. I wish mild and cyclic was mentioned here. And mention that it takes a really good doc to role their sleeves up, to get an accurate diagnosis. sigh***
@@garrettbenson7743 Generally, people feel better when the cycle is "on". (higher cortisol gives energy and relieves pain) Dr Theodore Friedman has a YT channel with very good info. All the best to you! PS Cushing's is nuanced. I did not have fat on my neck or stretch marks. I kept my weight gain to only 40 lbs. -trying to take care of myself. I was very beat down by the time I had an adrenalectomy - and was actually under weight/emaciated. Mild, cyclic is no joke.
Do yourself a favor. Look at The Adrenal Center in Tampa FL. If you click on the interest button, you will fill out a lengthy online form. It asks questions about medical history and labs. They are very quick to respond to your interest form. They will talk to you about how to send them your labs and scans. All of your info will be evaluated by Dr T Carling. He is the #1 ranked adrenal surgeon in the US. The center attracts people worldwide to have surgery with Dr Carling. You will be set up to have a phone call with Dr Carling to discuss your condition. I know the center accepts a lot of insurance. Do not know about your VA benefits, they will discuss it with you. Read everything you can from their website, a wealth of knowledge. Hope this helps.
First of all thanks prof Zach ❤ Second, regarding the High dose dexamethasone supersession test, if it's done to a Cushing's disease with a pituitary adenoma it's making it stop releasing ACTH ? Isn't adenoma secretion of hormones independent of any other exogenous hormones or am I getting it wrong or it's a different type?
Very keen to look at the Resources etc as you mentioned, however the link returns with link not working. Is it as trying to view from London UK? Would love to have access. Have liked and subscribed. M. Thanks
![Twenty One Pilots - The Line (from Arcane Season 2) [Official Audio]](http://i.ytimg.com/vi/XCz7WUotXs8/mqdefault.jpg)
Man, anyone else just going on a binge of their clinical medicine videos?
I watch at 3x speed when reviewing, using script editor in chrome:
• Ctrl+shift+j
• $('video').playbackRate=3
• Enter
(It can go in decimals, even up to 16x)
You got it, brother
not only is Zach an amazing teacher, he has faster reflexes than all of us combined
thank you for sitting one day and think about creating this channel you and your whole team thank you so much
Your videos are the best! Your videos deserve a ton of love from everyone viewing them...I always get a ton of value from your Vids! Thank you, thank you!
I thank God everyday for this channel
Man these are the best medicine contents I've ever seen thank you a lot!!
The amount of creativity and information is beyond words✨
19:00 - He's seriously nerding-out on the vasoconstrictive mechanisms. Love it!
Great video, thanks Ninja Nerd!
you have made this so easy to remember! THANK YOU!
Quite lucid
Thank you Prof
You are indeed impacting on humanity🎉🎉🎉❤
Was struggling with this topic. Thank you!
I like the new videos more showing the manifestation of the clinical signs in real life it s really cool and the approch to diagnosis and i hope that u make some videos about gyneco clinical medicine
this is a beautiful explanation of the disorder
Very helpful and not time wasting video.
Ty my friend
Studying for my FNP certification exam, thank you!!!
Thank you so much!! Super helpful for my finals
Thank you mr the best explication ever despite I study in French but your explanation is more detailed so I prefer always to see it
Thank you very much Prof Murphy. You are Awesome.
As per usual, amazing video! Thank you Thank you Thank you!
Thank you so much! You are an amazing teacher!
Very good video, I have cushing disease cause by a pit adenoma, my red flag was not getting my menstrual cycle/having issues getting pregnant, also have a cushing body, had surgery on 2018 that fail, now not cadidate to have surgery, just did radiation and taking levoketoconazole to lower my cortisol levels
Hello I was finally diagnosed with Cushing disease in 2006 after years of going to different doctors and being mis diagnosed I had a tumor on my pituitary had surgery and within a year the tumor came back no doctor in my state wanted to do a second surgery because the tumor was close to my optic nerve my doctor found Dr.Kelly in California that specialized in tumors in 2008 I was in surgery for 10 hours because of the amount of scar tissue but he got the tumor out through my nose I have to take prednisone for the rest of my life and thyroid medicine
@LK-fy4dd I had the transphenoidal surgery and symptoms continue. Some days are worse than others. I'm trying to find an endo who can really help me. My last one moved to NYC and was good.
Great lecture in all parts
Great video. Thank you, Ninja Nerd!
i love ninja nerd so much
Brilliant channel & brilliant videos 👍🏻
Thank you sir for making it easy for me
thankyou prof, im from indonesia n always watch ur video, and help me, thankyou prof !!!
Interesting lecture, thanks! I guess similar symptoms could also develop from glucocorticoid abuse in sports
please can you put clinical medicine lectures in playlists
thanks so much proff murphy
Hirtuism is just a small amount of hair directly under the ear, along the peterigoids which is the 'jawline'. Bone lengthening in this area is typically the result of genetic hormone imbalances and changes (diapause for example), including congenital deafness, ASD, etc. The bone lengthening in this area is what can give the masculine appearance. Even with the downy hair the appearence is still typically feminine with increased fat around the lower abdomen and hips.
Once my doctor saw the elevated blood pressure, with the extended stomach, with the buffalo hump, with the scalp acne, with the loss of emotional control, the incredible weight gain, it should have been a clue.
Any update ??
@@naturelovers6987 Thanks, no. I went in for my annual physical and he did not look at anything or touch anything. He sat on his stool and told me I didn't have Cushings. Without examining me. So no,he is not my doctor anymore.
Thanks alot❤from India🇮🇳
Thanks for the information 🙂
Could years of chronic, terrorizing stress (a constant state of fight or flight) cause Cushing's? I'm talking domestic violence...I am 99.9% sure I have Cushing's (all symptoms). Getting tested next week.
Hlo please share about your reports because i was also in chronic stress after that i got all Cushing symptoms I don't what to do please share your regarding this 😢😢😢
Question: If the suspected cause of Cushing Disease is a pituitary adenoma, wouldn't the high dose dexamethasone test suppress only the cortisol and the levels of ACTH would remain high? Cramming for my PANCE right now. Take it in 3 weeks. These videos are saving my life!!!
Actually u did a really good question. First, you have to remember that almost all patients with Cushings disease have *micro*adenoma that have a really good response to CRH test and corticosteroids suppression test. However, some *macro*adenomas isn’t able to response adequately to these test. Because, they have almost more impact in hormones than the rest of the pituitary gland, different from the microadenomas ones.
Biochemical assessment of Cushing's disease in patients with corticotroph macroadenomas.
Clinical and biochemical characteristics of adrenocorticotropin-secreting macroadenomas.
Love your vidoes! They have helped me so much!
I have several of these symptoms including fatty hump between shoulders, significant trunk fat, uncontrolled hypertension despite 2 hypertensive meds, round face, adult acne in my 60's and osteoporosis with history of severe T9 compression fracture and other minor compression fractures, but I have not yet had any cortisol tests or the dexamethasone test. I have had two PET scans due to having smoldering multiple myeloma which did not reveal either pituitary or adrenal gland tumors. However, I do have a parotid adenoma and a suspected adenoma on the right dome of the hemidiaphragm. I am wondering if either of these could cause Cushing's Syndrome? If not, then I suspect I may have Cushing's Syndrome from years of inhaled corticosteroids for my asthma as well as 8 months of prednisone for polymyalgia rheumatica and occasional prednisone for chronic bronchitis and a few bouts of pneumonia. I would really like to be able to ask my PCP intelligent questions about getting more testing, so I'd appreciate any insights.
The types of questions to ask a GP or consultant would be very helpful for patients. Agree.
Thank you for you help! And nice tattoos!
Love you, ninja nerd!!!
love this channel
I love you so so so much.. thanks a lot Dr.. what a great job!
Loved the video! I was diagnosed with PCOS & insulin resistance from my obgyn but my rheumatologist agreed it would also be a good idea to see an endocrinologist to check for Cushings when I asked if I could have both. My Corozal level is high but I don't have a huge hump on my back and I have thick wrists and ankles, overweight, diabetes... face is round/wide but I am not sure if it's as "moon face" as your example. I had Tinea incognito for over 10 years (fungal infection that was made worse by steroids being prescribed to treat the rash and they kept giving me steroids for years on and off until i finally found a good dermatologist that figured it out)... I also suffered from MRSA outbreaks for years (but only when my immune system was compromised due to the Tinea incognito), very weak immune system (flu would land me in the hospita every year turning into Pneumonia or other long term respiratory issue), chronic inflammation and muscle weakness/ pain. I am also unable to get pregnant and my doctor said that even if we did successfully conceive, it would probably be too high-risk to carry the baby to full term. I just keep wondering... could it be Cushings even if I don't have the big physical "identifiers" for it? At this point- I honestly hope it is Cushings just to get some answers. I have a new patient appointment with an endocrinologist and I can only hope they are as well informed as you! 🤞🤞🤞🤞🤞🤞. ♡
Any update ??
You are amazing, thanks a ton
Wow! It’s amazing. Any of us are alive. What type of doctor do you recommend to diagnose Cushings syndrome/disease? hi I’m an anal cancer survivor and I just had my annual CT scan. It came back with minimal uptake in the anal canal, but I have a hump on my back and I have suffered from chronic stress. Heart palpitations/sweating.. I prefer to find a natropath.
All of these high quality videos and I still failed 🔥🔥🔥
I have pituitary and adrenal adenomas. I cannot get the VA to do anything related to cushings. They just keep telling me they are watching the tumors. My quality of life is going down fast. They won’t take the tumors out, and blood work comes back with 4 items high (ADH, cortisol, TSH, B12) and 3 items low (Imm gran#, eosin#, baso#) What can I ask them to do so that the Endo will accept its cushings? She just says I’m weird and won’t consider cushings. But I can tell something is wrong with my body. And it’s been 8 years….
Prayers for you - 8 years is TOO long! Can you get a different endo.?
Even endos expect very overt symptoms, as listed in this vid. And Cushie's suffer greatly especially when they have mild or cyclic Cushing's. I wish mild and cyclic was mentioned here. And mention that it takes a really good doc to role their sleeves up, to get an accurate diagnosis.
sigh***
@@janesjourney9564thanks for your prayers. I did not know about cyclic cushings. Thank you!
@@garrettbenson7743 Generally, people feel better when the cycle is "on". (higher cortisol gives energy and relieves pain) Dr Theodore Friedman has a YT channel with very good info. All the best to you!
PS Cushing's is nuanced. I did not have fat on my neck or stretch marks. I kept my weight gain to only 40 lbs. -trying to take care of myself. I was very beat down by the time I had an adrenalectomy - and was actually under weight/emaciated. Mild, cyclic is no joke.
Do yourself a favor. Look at The Adrenal Center in Tampa FL. If you click on the interest button, you will fill out a lengthy online form. It asks questions about medical history and labs. They are very quick to respond to your interest form. They will talk to you about how to send them your labs and scans. All of your info will be evaluated by Dr T Carling. He is the #1 ranked adrenal surgeon in the US. The center attracts people worldwide to have surgery with Dr Carling. You will be set up to have a phone call with Dr Carling to discuss your condition. I know the center accepts a lot of insurance. Do not know about your VA benefits, they will discuss it with you. Read everything you can from their website, a wealth of knowledge. Hope this helps.
Love these videos!
Great video!😊
Can you talk about Sarcoidosis please?
wow, thank you
good teacher bigman
Love you sir lots of love from Afghanistan 🇦🇫
Thank you so much ❤!
Great work
Thank you!
thank you
im gonna get hihg grade after watching this high yield video
Thanks alllot
What a legend
The goat 🙌🏾
Thank you so much ☺️
Your videos are super helpfull !!!!!
Very helpful 💓
Since you came on the scene, we now have practitioners who can explain things bettet
Thank you so much ❤❤❤❤
Amazing!
Love youuuu ninja nerd :)
First of all thanks prof Zach ❤
Second, regarding the High dose dexamethasone supersession test, if it's done to a Cushing's disease with a pituitary adenoma it's making it stop releasing ACTH ? Isn't adenoma secretion of hormones independent of any other exogenous hormones or am I getting it wrong or it's a different type?
Thanks a lot
You are amazing!!
Superhelpfull for my finals .. best wishes , from iraq , any body from iraq ?
Very keen to look at the Resources etc as you mentioned, however the link returns with link not working. Is it as trying to view from London UK? Would love to have access. Have liked and subscribed. M. Thanks
The legend is getting old 😢
Plz do make videos on uworld
U r fascinating my friend
You’re the best ❤
11 th like sir, I'm pratheesh from india( tamilnadu).big fan of you sir.say one hii sir.
Any idea if inhaler like trelegy ellipta can cause this Cushing problem
THANKYOU THANKYOU!!!
Legend 🫡
Thanks prof
Perfect
Thanks
Can you just tell me why just alpha 1 sensitivity increases why not beta 1 & 2 ?????????
Amazing
Always love
Thanks 🙏🙏🙏🙏
❤❤❤lovedd it
Gracias
good
Love you
Nice ❤❤
Savior❤
Commenting for the algorithm
18:57 HTN
beast
❤
❤❤❤❤❤