Cushings And Addisons Disease

Question 1

What is Cushing disease

Answer 1

When would have the over production of the cortisol

Question 2

What is Addison’s disease

Answer 2

Under production of the cortisol

Question 3

What is the difference between Cushing disease and Cushing syndrome

Answer 3

Disease: tumour on the pituitary gland so more acth made
Syndrome: the collection of the symptoms

Question 4

What are the symptoms of Cushing disease

Answer 4

Hypertension
Hyperlipidemia
Purple striate stretch marks
Moo face
Abdominal obesity

Question 5

What can cause Cushing

Answer 5

Pituitary tumour
Adrenal gland tumour
Ectopic factors (small cell lung tumour,migration)
Drugs (steroids)

Question 6

How does Cushing lead to hypertension

Answer 6

Excess cortisol would ac like aldosterone does, so would increase the uptake of water

Question 7

How does Cushing lead to osteoporosis

Answer 7

Would have the loss of the bone matrix due to the calcium disturbances

Question 8

What are the rare effects of Cushing

Answer 8

Mental chafes
Hypogonadism (menstral problems in women)
Hirsutism (excess growth of body hair, especially on the face)

Question 9

What order would you do a diagnosis

Answer 9

C (clinical tests)
B (biochemical tests)
R (radiology)

Question 10

What is the clinical test for Cushing

Answer 10

Dexamethasone (high level of 8mg) would stop the secretion of ACTH
If the levels remain high this would show the Cushing disease

Question 11

How would you locate the area that causes the Cushing

Answer 11

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)

Question 12

What is the cause of Addison’s disease

Answer 12

Adrenal failure or the chronic adrenal insufficiency
Destructive atrophy that would be caused by the immune response

Question 13

Why does Addison’s cause skin hyperpigmentation

Answer 13

Increased ACTH and other products of the POMC (alpha and gamma MSH) would stimulate the melanocytes to make melanin

Question 14

What is the negative feedback mechanism in Addison’s disease

Answer 14

Decreased cortisol, ant. Pituitary would make more POMC TO MAKE ACTH would then stimulate the melanocytes

Question 15

What test would be used to identify Addison’s disease

Answer 15

SYNACTHEN
Synthetic ACTH
would normally have the levels of cortisol increase.
When have addisons would not have the levels increase

Question 16

What is the addisonian crisis

Answer 16

Addison’s that would lead to death
Need:
Rehydrataton
Intravenous hydrocortisone (need to know if on any meds)
Correction of the hypoglycaemia

Question 17

What can cortisol do

Answer 17

Increased blood and protein levels in the blood stream

Question 18

What is iatrogenic Cushing’s syndrome

Answer 18

Cushings that would develop by the use of cortisol drugs

Question 19

What effect would cortisol have on the body that would lead to the increased bacterial infections

Answer 19

Would be anti-inflammatory and the immunosuppressant
So the body would then not be able to respond to the bacteria in the body

Question 20

What are the other symptoms of the Cushing’s syndrome

Answer 20

Steroid diabetes
Immunosuppression
Anti-inflammation
Hypertension (cortisol would have the aldosterone like effects on the body)
Hyperglycaemia

Question 21

What would happen in the addisons crisis

Answer 21

The hypoglycaemia
Nausea
Vomiting
Hypotension
Dehydration (no fluid retention)

Question 22

What would need to be done to correct the additions crisis

Answer 22

Intravenous fluids (fix the hypotension)
Correct the hypoglycaemia
Intravenous Hydrocortisone