Cushings And Addisons Disease Flashcards
What is Cushing disease
When would have the over production of the cortisol
What is Addison’s disease
Under production of the cortisol
What is the difference between Cushing disease and Cushing syndrome
Disease: tumour on the pituitary gland so more acth made
Syndrome: the collection of the symptoms
What are the symptoms of Cushing disease
Hypertension
Hyperlipidemia
Purple striate stretch marks
Moo face
Abdominal obesity
What can cause Cushing
Pituitary tumour
Adrenal gland tumour
Ectopic factors (small cell lung tumour,migration)
Drugs (steroids)
How does Cushing lead to hypertension
Excess cortisol would ac like aldosterone does, so would increase the uptake of water
How does Cushing lead to osteoporosis
Would have the loss of the bone matrix due to the calcium disturbances
What are the rare effects of Cushing
Mental chafes
Hypogonadism (menstral problems in women)
Hirsutism (excess growth of body hair, especially on the face)
What order would you do a diagnosis
C (clinical tests)
B (biochemical tests)
R (radiology)
What is the clinical test for Cushing
Dexamethasone (high level of 8mg) would stop the secretion of ACTH
If the levels remain high this would show the Cushing disease
How would you locate the area that causes the Cushing
When dexamethasone is added
Suppresses the cortisol production in the pituitary (would then lower the levels)
Would not suppress in the adrenal or in the ectopic area (would be high)
What is the cause of Addison’s disease
Adrenal failure or the chronic adrenal insufficiency
Destructive atrophy that would be caused by the immune response
Why does Addison’s cause skin hyperpigmentation
Increased ACTH and other products of the POMC (alpha and gamma MSH) would stimulate the melanocytes to make melanin
What is the negative feedback mechanism in Addison’s disease
Decreased cortisol, ant. Pituitary would make more POMC TO MAKE ACTH would then stimulate the melanocytes
What test would be used to identify Addison’s disease
SYNACTHEN
Synthetic ACTH
would normally have the levels of cortisol increase.
When have addisons would not have the levels increase
What is the addisonian crisis
Addison’s that would lead to death
Need:
Rehydrataton
Intravenous hydrocortisone (need to know if on any meds)
Correction of the hypoglycaemia
What can cortisol do
Increased blood and protein levels in the blood stream
What is iatrogenic Cushing’s syndrome
Cushings that would develop by the use of cortisol drugs
What effect would cortisol have on the body that would lead to the increased bacterial infections
Would be anti-inflammatory and the immunosuppressant
So the body would then not be able to respond to the bacteria in the body
What are the other symptoms of the Cushing’s syndrome
Steroid diabetes
Immunosuppression
Anti-inflammation
Hypertension (cortisol would have the aldosterone like effects on the body)
Hyperglycaemia
What would happen in the addisons crisis
The hypoglycaemia
Nausea
Vomiting
Hypotension
Dehydration (no fluid retention)
What would need to be done to correct the additions crisis
Intravenous fluids (fix the hypotension)
Correct the hypoglycaemia
Intravenous Hydrocortisone
