Cushing’s syndrome Flashcards
Difference between Cushing’s syndrome & disease
- signs & symptoms of prolonged abnormal elevation of cortisol
- pituitary adenoma —> xs ACTH —> Cushing’s syndrome
Explain the features of Cushing’s causing roundness in middle and limb features
- round moon face
- central obesity
- abdominal striae
- buffalo hump
- proximal limb muscle wasting
Clinical features of Cushing’s caused by high levels of stress hormone
- hypertension
- cardiac hypertrophy
- hyperglycaemia
- depression
- insomnia
Skin and bone symptoms of Cushing’s
- osteoporosis
- easy bruising & poor skin healing
Causes of Cushing’s syndrome
- exogenous steroids
- Cushing’s disease
- adrenal adenoma
Aetiology of praneoplastic Cushing’s
Ectopic ACTH secretion tumour
Most common cause of paraneoplastic Cushing’s
Small cell lung cancer
In a low dose (1 mg) dexamethasone suppression test (DST) what would the levels of cortisol be in a normal patient
Low
In a low dose (1 mg) dexamethasone suppression test (DST) what would the levels of cortisol be in Cushing’s syndrome
High/normal
When do you perform a high dose (8 mg) DST
Determine underlying cause of elevated cortisol
In high dose DST a low cortisol suggest
Cushing’s disease (pituitary)
If cortisol is high in high dose DST the underlying cause of elevated cortisol is
ACTH acting on adrenals
In high dose DST a high cortisol and low ACTH indicates
Adrenal Cushing’s
In high dose DST a high cortisol and high ACTH indicates
Ectopic ACTH
Limitation of 24hr urinary free cortisol
Does not determine underlying cause
