cushing's Flashcards
cushing’s syndrome
signs and symptoms after prolonged abnormal cortisol elevation
cushing’s disease
pituitary adenoma secretes excessive ACTH
cushing’s syndrome features
moon face central obesity abdo striae buffalo hump proximal limb wasting htn cardiac hypertrophy hyperglycaemia (T2DM) depression easy bruising osteoporosis
causes of Cushing’s syndrome
exogenous steroids
Cushing’s disease
adrenal adenoma
paraneoplastic cushing’s
dexamathasone suppression test
dose of dexamethasone at night –> cortisol and ACTH measured in morning –> does dexamethasone suppress normal AM cortisol spike
do low dose –> if normal cuhsing’s excluded, if abnormal do high dose to differentiate between causes
high dose dexamethasone suppresion test results: pituitary adenoma
low cortisol and ACTH
high dose dexamethasone suppresion test results: adrenal adenoma
cotrisol normal
ACTH low
high dose dexamethasone suppresion test results: ectopic ACTH (paraneoplasitc)
cortisol and ACTH normal
Mx
remove underlying cause