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Endocrine > Cushing's Syndrome > Flashcards

Cushing's Syndrome Flashcards

1
Q

What is Cushing’s syndrome?

A

Adrenal gland is targeted by trophic hormones leading to excess glucocorticoids

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2
Q

What does Cushing’s syndrome result in?

A

Excess cortisol

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3
Q

What is the main ACTH dependent cause of Cushing’s syndrome?

A

Iatrogenic steroids

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4
Q

What type of cause are iatrogenic steroids?

A

An exogenous cause

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5
Q

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

A

Cushing’s disease

Small cell lung cancer

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6
Q

What is Cushing’s disease?

A

Increased ACTH due to a pituitary adenoma

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7
Q

How does small cell lung cancer cause Cushing’s syndrome?

A

Releases ectopic ACTH

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8
Q

What are the main symptoms of Cushing’s syndrome?

A 
Moon face
Central obesity 
Abdominal striae 
Proximal limb wasting 
Buffalo hump 
Pigmentation
Easy bruising 
Elevated blood pressure
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9
Q

Why is there pigmentation with Cushing’s syndrome?

A

Due to the increased ACTH

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10
Q

What is the best diagnosis of Cushing’s syndrome?

A

Overnight dexamethasone suppression test

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11
Q

What is low dose dexamethasone?

A

1mg

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12
Q

What is high dose dexamethasone?

A

8mg

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13
Q

What does low dose dexamethasone exclude if there is no response?

A

Cushing’s disease

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14
Q

What is an alternative investigation that can be done for Cushing’s syndrome?

A

24 hour urinary free cortisol

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15
Q

What can mimic cushing’s?

A

Psuedo-cushing’s
due to excess alcohol consumption or severe depression

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16
Q

What metabolic disturbance can occur in someone with cushing’s syndrome?

A

Hypokalaemic metabolic alkalosis

17
Q

What is the management of cushing’s syndrome?

A

Removal of the tumour- main managment

18
Q

What needs to be done before surgical management (removal of the tumour) in someone with Cushing’s syndrome?

A

Normalisation of hypercortisolaemia with medical therapy prior to operating

19
Q

What medical management can be used in someone with Cushing’s syndrome?

A

Metyrapone

20
Q

What is the function of metyrapone?

A

Blocks the steroid synthesis pathway

21
Q

What is usually required in someone post operatively?

A

Successful treatment of Cushing’s disease leads to cortisol deficiency and subsequently steroid replacement post operatively is essential.

22
Q

What would
Suppressed ACTH
Not suppressed cortisol
indicate?

A

Cushing’s syndrome due to other causes (e.g. adrenal adenomas)

23
Q

What does suppressed ACTH and suppressed cortisol indicate?

A

Cushing’s disease (i.e. pituitary adenoma → ACTH secretion)

24
Q

What would cortisol and ACTH not suppressed suggest?

A

Ectopic ACTH syndrome

Endocrine (27 decks)

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