Cushings Syndrome Flashcards
Cortisol is what type of hormone?
Catabolic
What is Cushings?
Hypersecretion of Corticosteroids inc Cortisol
Insulin antagonism may cause?
Diabetes Mellitus
Symptoms and Signs of Cushings Syndrome? (15)
Central Obesity Hypertension Glucose Tolerance Hirsutism Amenorrhoea Purple Striae Plethoric Faces Easy Bruise Osteoporosis Personality Changes ACNE Edema Headache Poor Wound Heal Moon Face
Most common cause of Cushings Syndrome
Corticosteroid Therapy eg IBD, Asthma
ACTH Dependent causes of Cushings? (2)
Pituitary Tumour (Cushings Disease) Ectopic ACTH Secretion (Lung Carcinoid)
ACTH Independent causes of Cushings? (2)
Adrenal Tumour (Adenoma or Carcinoma Corticosteroid Therapy
What happens if CRH and ACTH decreases in problems with Adrenal Cortex?
Cortisol Increases
What happens if CRH decreases and ACTH increases in Secondary Hypersecretion in problems with Pituitary?
Cortisol Increases
Screening Tests for Cushings and Normal Ranges?
24 Hr Urinary Free Cortisol: Normal 14-135
1mg Overnight Dexamethasone Suppression Test at Midnight Normal <50nmol
How to localise cause of Cushings?
MRI Sella
CT Adrenal
CT Chest
How to treat Cushings?
Surgery Adrenal Hormone Synthesis Inhibitors Destroy Adrenocortical Cells Medications Radiotherapy Bilateral Adrenelectomy
Name the four Adrenal Hormone Synthesis Inhibitors for use in Cushings?
Ketoconazole
Metyrapone
Aminoglutethimide
Etomidate
Name the drug used to destroy Adrenocortical cells in Cushings?
Mitotane
