Cushing's syndrome

Question 1

Cushing’s syndrome (14)

Answer 1

• Hirsutism
• Facial plethora
• Moon facies
• Violaeceous Striae
• Acne, Telangiectasia
• Dorso-cervical fat pad
• Easy bruising
• Central obesity
• Skin thinning
• Proximal myopathy
• HTN
• MSE
• Bitemporal hemianopia (not related to glucocorticoids)

Question 2

Investigations (6)

Answer 2

• Dexamethasone suppression test
• 24 hour urinary cortisol
• Early AM cortisol
• ACTH
• CRH stimulation test
• MRI brain vs CT adrenals

Cx screening:
- HbA1c, Glucose level
- Spine XR, DEXA