Adrenal gland

Question 1

What is Cushings syndrome?

Answer 1

Chronic glucocorticoid excess
Loss of normal feedback mechanisms of HPA axis
Loss of circadian rhythm

Question 2

What are the ACTH dependent causes of Cushing’s syndrome?

Answer 2

1. ACTH-secreting pituitary adenoma (Cushing’s disease)
2. Ectopic ACTH production
3. Ectopic CRF production

Question 3

What are the ACTH independent causes of Cushing’s syndrome?

Answer 3

1. Iatrogenic (steroid use)
2. Adrenal adenoma/cancer
3. Adrenal nodular hyperplasia

Question 4

What can cause an ectopic ACTH production?

Answer 4

Small cell lung cancer and carcinoid tumours

Question 5

In an adrenal adenoma/cancer, what would a dexamethasone suppression test show?

Answer 5

Dexamethasone doesn’t suppress cortisol

(tumour is autonomous

Question 6

What symptoms can you get in Cushing’s syndrome?

Answer 6

Increased weight
Mood change
Proximal weakness
Gonadal dysfunction