Cushing's syndrome

Question 1

what is cushing’s syndrome?

Answer 1

A condition caused by prolonged exposure to high levels of cortisol.

Question 2

signs and symptoms of Cushing’s Syndrome?

Answer 2

Truncal Obesity, supraclavicular fat pads, buffalo hump, moon face

BP:
Muscle wasting->weakness, thin extremities, fatigue

Thin friable skin: bruises, striae, acne, hyperpigmentation
purple/red stria on breasts, buttocks, and abdomen

Poor wound healing

Osteoporosis-> back pain

Feminization in men: Gynecomastia & testicular atrophy

Hirsutism of body and face (females), menstrual irregularities; thinning hair

Question 3

Medication and treatment for cushing’s syndrome

Answer 3

Medications to Lower Cortisol Levels
Ketoconazole – Antifungal that inhibits adrenal steroid production.

Metyrapone – Inhibits cortisol synthesis by blocking 11-beta-hydroxylase.

Mitotane – Used for adrenal carcinoma; destroys adrenal tissue and reduces cortisol.

Mifepristone (Korlym) – Cortisol receptor blocker, used in Cushing’s with type 2 diabetes.

Pasireotide – A somatostatin analog that inhibits ACTH release in pituitary tumors.
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2. Surgical Treatment
Transsphenoidal surgery – Removal of pituitary adenoma (Cushing’s disease).

Adrenalectomy – Removal of adrenal tumors (open or laparoscopic).

Ectopic tumor removal – Surgery to remove ACTH-secreting tumors (e.g., lung cancer).
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3. Radiation Therapy
Used for pituitary adenomas when surgery is not an option or was incomplete.
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4. Discontinuation of Exogenous Corticosteroids
If Cushing’s is caused by long-term steroid use, the dose should be tapered slowly to avoid adrenal insufficiency.