Cushing Syndrome

Question 1

Heypersecretion of the adrenal cortex producing excess cortisol

Answer 1

Cushing’s Syndrome

Question 2

Bilateral hyperplasia of the adrenal cortex due to elevated levels of adrenocorticotropic hormone (ACTH) – could be result of pituitary tumor – neoplasm of adrenal cortex – latrogenic from long-term steriod use

Answer 2

Etiology of Cushing’s Syndrome

Question 3

Rounded or “moon” shaped face with acne – presence of a “buffalo hump” (prominent supraclavicular and dorsal cervical fat pads) – Truncal obesity

Answer 3

Signs and Symptoms of Cushing’s Syndrome

Question 4

24 hr. urine test to establish elevated cortisol levels in the urine – suppression of cortisol by dexamethasone (a syntheetic glucocorticoid)

Answer 4

Diagnosis for Cushing’s Syndrome

Question 5

Giving low-dose dexamethasone to normal patients leads to inhibition of ACTH secretion – urinary cortisol will usually decrease

Answer 5

Diagnosis for Cushing’s Syndrome

Question 6

In patients with Cushing’s syndrome (non-pituitary) and Cushing’s disease (pituiary tumor), cortisol levels will

Answer 6

Not Decrease

Question 7

A high-dose test will be sufficient to block enough ACTH from the pituitary tumor so the Cushing’s disease patient will have a diminished level of cortisol while the Cushing’s syndrome patient will not

Answer 7

Summary of Diagnosis

Question 8

Surgery to remove tumor, drug or radiation therapy, total adrenalectomy

Answer 8

Treatment for Cushing’s Syndrome