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OSCEs > Cushing's Syndrome > Flashcards

Cushing's Syndrome Flashcards

1
Q

General inspection

A

Central/truncal obesity

Peripheral muscle wasting

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2
Q

Hands

A

Reduced skin fold thickness (cigarette paper skin)

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3
Q

Arms

A

Hypertension
Proximal myopathy (shoulder abduction weakness)
Bruising

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4
Q

Face

A

Moon facies
Acne
Hirsutism
Facial plethora

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5
Q

Chest/back

A

Gynecomastia in males
Buffalo hump (interscapular fat pad)
Kyphosis (vertebral wedge fracture secondary to osteoporosis)

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6
Q

Abdomen

A

Purple striae

Central obesity

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7
Q

Legs

A

Bruising

Weak hip girdle strength (proximal myopathy)

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8
Q

Further investigations

A 
Blood tests (glucose, U&E- hypokalemia)
Bone scan
Urine dipstick (glucosuria)
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9
Q

Differential diagnosis for proximal myopathy

A 
Cushing's syndrome
Acromegaly
Hyperthyroidism
Muscular dystrophy
Myasthenia gravis
Polymyositis
Dermatomyositis
Hypo/hyper K+/Ca2+
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10
Q

Investigating non-iatrogenic Cushing’s syndrome?

A
  1. 48hr dexamethasone suppression test
  2. 24hr urinary free cortisol
  3. CT abdomen/adrenals
  4. MRI (pituitary fossa)
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OSCEs (7 decks)

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