Cushing Syndrome

Question 1

Definition of Cushing syndrome

Answer 1

Cushing’s syndrome is a hormonal disorder caused by prolonged exposure to high levels of cortisol, a steroid hormone produced by the adrenal glands.

Question 2

Function of cortisol

Answer 2

Cortisol plays a crucial role in various physiological processes, including regulation of blood pressure, glucose metabolism, and the body’s response to stress.

Question 3

Cushing syndrome can occur due to which factors /causes

Answer 3

Endogenous and exogenous factors

Endogenous factors include
A.ACTH-dependent (Cushing disease and ACTh ectopic syndrome)
B. ACTH independent (adrenal adenoma/adenocarcinoma)

Exogenous factor -corticosteroids drugs

And can be occur due to stress and pregnancy

Question 4

Symptoms and signs of Cushing syndrome

Answer 4

Weight gain, particularly in the face (moon face), upper back (buffalo hump), and abdomen
Thin, fragile skin that bruises easily
Muscle weakness and fatigue
Red stretch marks (striae) on the skin
Excess hair growth (hirsutism)
Acne and other skin problems
Easy bruising
Slow healing of cuts and infections
Irregular menstrual cycles in women
Erectile dysfunction in men
High blood pressure (hypertension)
High blood sugar levels (hyperglycemia)

Question 5

Causes of Cushing syndrome with explanation

Answer 5

Exogenous corticosteroid use: Taking corticosteroid medications, such as prednisone

Cushing’s disease: occurs when a pituitary adenoma (a benign tumor in the pituitary gland) produces excessive amounts of adrenocorticotropic hormone (ACTH), leading to increased cortisol production.

Adrenal gland tumors or hyperplasia: Tumors in the adrenal glands or adrenal hyperplasia can result in excess cortisol production.

Ectopic ACTH production: Some tumors outside the pituitary gland, such as small cell lung cancer, can produce ACTH and cause Cushing’s syndrome.

Question 6

Physiology of corticosteroids

Question 7

Regulation of gluco

Question 8

1st line tests for Cushing Syndrome diagnosis

Answer 8

Dexamethasone suppression test
24-hours urine cortisol
Salivary corpisol at 11pm

Question 9

Instrumental diagnostics

Answer 9

Pituitary MRI: Magnetic Resonance Imaging (MRI) of the pituitary gland helps identify the presence of a pituitary adenoma.

Adrenal CT or MRI: Imaging of the adrenal glands using Computed Tomography (CT) or MRI helps detect adrenal tumors or hyperplasia.

Chest and Abdominal CT or MRI: These imaging techniques can help locate ectopic ACTH-producing tumors.