Cushing's Disease

Question 1

Cushing syndrome causes (4)

Answer 1

• use of corticosteroid medications
• infrequently from excessive corticosteroid production
• tumor of pituitary gland
• normal feedback mechanisms that control function of adrenal cortex become ineffective

Question 2

Cushing syndrome clinical manifestations (11)

Answer 2

• enlarged supraclavicular fat pads
• osteoporosis
• hypertension
• muscle wasting in extremities
• poor wound healing
• moon face
• dark facial hair (women)
• cardiac hypertrophy
• obesity
• abdominal striae
• amenorrhea (women)

Question 3

assessment and diagnostic findings (2)

Answer 3

• 2 tests (all must be abnormal) –> serum cortisol, urinary cortisol (24 hr collection), low dose dexamethasone tests (overnight)
• increased Na, serum glucose, decreased K and blood eosinophils

Question 4

What is the low dose dexamethasone suppression test

Answer 4

serum cortisol levels increase early AM and decrease in evening. this variation is lost in patients with cushings, so the dexamethasone test shows that

Question 5

medical management of Cushing’s disease (7)

Answer 5

• pituitary tumor removal
• radiation of pituitary gland
• adrenal enzyme inhibitors
• if related to administration of corticosteroids: taper to minimum dose
• decreased risk of injury, infection
• encourage rest and moderate activity
• promote skin integrity