Cushing's

Question 1

What is the definition of cushing’s?

Answer 1

ACTH secreting pituitary tumour , causing the adrenal gland to secrete cortisol

Question 2

What are the risk factors for cushing’s?

Answer 2

Adrenal or pituitary tumours, long-term corticosteroids, female

Question 3

What is the presentation of cushing’s?

Answer 3

Round pink face
Round abdomen
Skinny and weak arms and legs
Thin skin and easy bruising
Buffalo hump
Purple striae on abdomen
High BP
Female balding

Question 4

What are the investigations for cushing’s?

Answer 4

24hr urine collection for urinary free-cortisol excretion
Dexamethasone suppression test - if no suppression, positive for cushing’s
U and Es - hypokalaemia and hypernatraemia

Question 5

What is the management for cushing’s?

Answer 5

Transphenoidal removal of the tumour
If patient develops hypocorticolism in first few days they are likely cured
Suspension of steroid use

Question 6

What are the complications of cushing’s?

Answer 6

Osteoporosis
Hypertension
Type 2 diabetes (glucocorticoids are anti-insulin)
Blood clots