Cushing's Syndrome in Adults

Question 1

What is the typical history associated with Cushing’s syndrome in adults?

Answer 1

Weight gain, particularly around the abdomen and face. Muscle weakness, fatigue. Hypertension, easy bruising.

Question 2

What are the key physical examination findings in Cushing’s syndrome in adults?

Answer 2

Central obesity, moon face, buffalo hump. Purple striae on abdomen. Muscle wasting, thin skin.

Question 3

What investigations are necessary for diagnosing Cushing’s syndrome in adults?

Answer 3

24-hour urinary free cortisol. Late-night salivary cortisol. Low-dose dexamethasone suppression test.

Question 4

What are the non-pharmacological management strategies for Cushing’s syndrome in adults?

Answer 4

Lifestyle modifications: diet, exercise. Monitor and manage comorbidities. Psychological support and counseling.

Question 5

What are the pharmacological management options for Cushing’s syndrome in adults?

Answer 5

Medications to control cortisol production: ketoconazole, metyrapone. Consider surgical options if caused by a tumor.

Question 6

What are the red flags to look for in Cushing’s syndrome patients?

Answer 6

Severe hypertension, uncontrolled diabetes. Rapid progression of symptoms. Signs of adrenal crisis: severe weakness, low blood pressure.

Question 7

When should a patient with Cushing’s syndrome be referred to a specialist?

Answer 7

Endocrinologist for diagnostic evaluation. Surgery for adrenal or pituitary tumors. Management of complications (e.g., osteoporosis, cardiovascular disease).

Question 8

What is one key piece of pathophysiology related to Cushing’s syndrome?

Answer 8

Excessive cortisol production. Can be due to exogenous steroids or endogenous causes (e.g., pituitary adenoma, adrenal tumor). Leads to characteristic physical changes and metabolic disturbances.