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.
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.
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.
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.
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 😢😢😢
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! 🤞🤞🤞🤞🤞🤞. ♡
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.
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.
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
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?
can it be that cortisl redistributes the fat to the center of mass because its a stress hormon and the body goes into survival mode to keep the body warm?
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
Me
It happens....most bizarre when it becomes a lifetime habit.
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✨
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
Great video, thanks Ninja Nerd!
you have made this so easy to remember! THANK YOU!
Was struggling with this topic. Thank you!
Sir your class are amazing 😍😍
Quite lucid
Thank you Prof
You are indeed impacting on humanity🎉🎉🎉❤
Studying for my FNP certification exam, thank you!!!
This video is SO WELL EXPLAINED THANK YOU
As per usual, amazing video! Thank you Thank you Thank you!
Thank you very much for your work❤❤❤
This was very helpful thank you
19:00 - He's seriously nerding-out on the vasoconstrictive mechanisms. Love it!
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
Very helpful and not time wasting video.
Ty my friend
this is a beautiful explanation of the disorder
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.
Brilliant channel & brilliant videos 👍🏻
Thank you very much Prof Murphy. You are Awesome.
Thank you so much! You are an amazing teacher!
you are awesome!
another review quickie sesh before cd thanks ninjanerd
Great lecture in all parts
Thank you so much!! Super helpful for my finals
good teacher bigman
Thanks for the information 🙂
Great video. Thank you, Ninja Nerd!
Interesting lecture, thanks! I guess similar symptoms could also develop from glucocorticoid abuse in sports
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.
thanks so much proff murphy
thankyou prof, im from indonesia n always watch ur video, and help me, thankyou prof !!!
Thank you so much 💐
Superb sir ji 🎉
Love your vidoes! They have helped me so much!
Thank you sir for making it easy for me
i love ninja nerd so much
Thanks alot❤from India🇮🇳
Thank you for you help! And nice tattoos!
please can you put clinical medicine lectures in playlists
You are amazing, thanks a ton
Great video!😊
love this channel
Thank you ❤
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.
Thank you
Thank you!
I love you so so so much.. thanks a lot Dr.. what a great job!
Thank you so much ❤!
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.
Great work
Can you talk about Sarcoidosis please?
Love you, ninja nerd!!!
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 😢😢😢
Love these videos!
Thank you so much ❤❤❤❤
wow, thank you
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 ??
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.
im gonna get hihg grade after watching this high yield video
Sir you are amazing love you from Pakistan ❤❤❤❤❤
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.
Thanks alllot
Thank you so much ☺️
All of these high quality videos and I still failed 🔥🔥🔥
Very helpful 💓
Amazing!
Thanks a lot
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.
thank you
Your videos are super helpfull !!!!!
U r fascinating my friend
The goat 🙌🏾
Love you sir lots of love from Afghanistan 🇦🇫
You are amazing!!
Any thoughts on CYCLIC Cushing's disease?
Plz do make videos on uworld
What a legend
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
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?
You’re the best ❤
can it be that cortisl redistributes the fat to the center of mass because its a stress hormon and the body goes into survival mode to keep the body warm?
Love youuuu ninja nerd :)
11 th like sir, I'm pratheesh from india( tamilnadu).big fan of you sir.say one hii sir.
❤❤❤lovedd it
So nice
Is it possible to have the this syndrome with a regular cyclus? The periode is heavy tho
Perfect
Thanks 🙏🙏🙏🙏
greet from ULM
THANKYOU THANKYOU!!!
Thanks prof
Nice ❤❤
Any idea if inhaler like trelegy ellipta can cause this Cushing problem
Amazing