Cushing's Syndrome Flashcards by Aboudi el masri

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

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

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High morning cortisol and midnight nadir.

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

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

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List some RFs for cushing’s syndrome.

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

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

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What are the common signs and symptoms of Cushing’s syndrome.

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+ menstrual irregularities
+ visual disturbances
+ dyspepsia / indigestion
+ bruising
+ ulcers
+ facial plethora and moon facies
+ hirsuitism, acne, gynaecomastia
+ diabetes
+ interscapsular fat pad, supraclavicular fatpad - buffalo hump
+ proximal myopathy
+ osteoperosis
+ mood

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What are the common signs of Cushing’s syndrome.

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

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What are some ddx for cushing’s syndrome?

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Q

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

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Q

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

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Q

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

ALSO DESCRIBE THE TEST

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Q

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

ALSO DESCRIBE THE TEST

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

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What are the supportive investigations for cushing’s syndrome?

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What are ALL the investigations for cushing’s syndrome?

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What are the preventative measures for cushing’s syndrome?

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Describe the management of cushing’s syndrome.

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Iatrogenic - taper and stop exogenous glucocorticoids

Note - typo - should be adrenal adenoma not carcinoma.

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

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Describe the FULL management of cushing’s syndrome.

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What are the complications of cushing’s syndrome?

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Must mention
1) Nelson Syndrome
2) Adrenal crisis

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

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