Cushing's sydnrome

Question 1

What hormone is elevated in Cushing’s syndrome?

Answer 1

Cortisol

Question 2

What are the symptoms/sings of Cushing’ syndrome?

Answer 2

Muscle wasting
Osteoporosis
Thin skin, stretch marks, bruising
Depression, psychosis
Hypertension, oedema

Question 3

How is Cushing’s syndrome diagnosed?

Answer 3

1. Steroid Suppression Test
   - Exogenous steroid administration should inhibit endogenous cortisol secretion
2. Urine free cortisol
3. Diurnal cortisol variation

Question 4

What is the most common cause of Cushing’s?

Answer 4

1. Pituitary tumour
   - Cushing’s disease
2. Adrenal Gland Adenoma
3. Ectopic Adrenal tissue
   - thymus, lung, pancreas

Question 5

In which aetiology of Cushing’s would ACTH levels be low? When would it be high?

Answer 5

Pituitary tumour - high

Ectopic adrenal tissue - low