Cushing's Syndrome

Question 2

What are the 3 zones of the adrenal gland. What are their functions and how are they regulated?

Answer 2

Question 3

What is the normal pattern of serum cortisol levels throughout the day.

Answer 3

High morning cortisol and midnight nadir.

Question 4

Define and distinguish between between cushing’s disease and cushing’s syndrome.

Answer 4

Question 5

What is the most common ACTH dependant cause of cushing’s syndrome? What is its prevalence?

Answer 5

Question 6

List some RFs for cushing’s syndrome.

Answer 6

Question 7

Cushing’ syndrome can be ACTH dependent or independent.
Describe the pathogenesis and common causes of
ACTH dependent cushing’s syndrome.

Answer 7

Question 8

Cushing’ syndrome can be ACTH dependent or independent.
Describe the pathogenesis and common causes of
ACTH dependent cushing’s syndrome.

Answer 8

Question 9

What are the common symptoms of Cushing’s syndrome.

Answer 9

+ menstrual irregularities

Question 10

What are the common signs of Cushing’s syndrome.

Answer 10

Question 11

What are the common signs of Cushing’s syndrome specific to ACTH independent causes.

Answer 11

Question 12

What are some ddx for cushing’s syndrome?

Answer 12

Question 13

What are the positive findings of cushing’s disease in the following tests:
1. 24 hr urinary free cortisol

Answer 13

Question 14

What are the positive findings of cushing’s disease in the following tests:
1. late night salivary cortisol

Answer 14

Question 15

What are the positive findings of cushing’s disease in the following tests:
1. 1mg overnight dexamethasone suppression test

ALSO DESCRIBE THE TEST

Answer 15

Question 16

What are the positive findings of cushing’s disease in the following tests:
1. 8mg high dose dexamethasone suppression test

ALSO DESCRIBE THE TEST

Answer 16

Question 17

What are the 5 key diagnostic investigations for cushing’s syndrome? Describe the tests and their findings.

Answer 17

Question 18

What are the supportive investigations for cushing’s syndrome?

Answer 18

Question 19

What are ALL the investigations for cushing’s syndrome?

Answer 19

Question 20

What are the preventative measures for cushing’s syndrome?

Answer 20

Question 21

Describe the acute management of cushing’s syndrome.

Answer 21

Iatrogenic - taper and stop exogenous glucocorticoids

Note - typo - should be adrenal adenoma not carcinoma.

Question 22

Describe the long-term management of cushing’s syndrome.

Answer 22

Question 23

Describe the FULL management of cushing’s syndrome.

Answer 23

Question 24

What are the complications of cushing’s syndrome?

Answer 24

Question 25

After performing a unilateral resection of the adrenal adenoma, will the patient also need cortisol replacement lik in a bilateral adrenalectomy?

Answer 25

After unilateral excision, cortisol levels may take several months to recover. Patients may be administered IV hydrocort postup following by oral pred on discharge.