Cushings Syndrome Flashcards
Cushings syndrome is caused by excess?
Corticosteroid
Cortisol is what type of hormone action?
Catabolic
What happens to insulin in Cushings?
Insulin Antagonism
Presentation of Cushings? (11)
Skin Atrophy Hypertension Proximal Myopathy Osteoporosis Growth Arrest Mooning Hypokalaemia Ostoepenia Amenorrhoea Hirtusim Central Obesity
Causes of Cushings? (5)
Pituitary Tumour ACTH Dependent Ectopic ACTH ACTH Independent Corticosteroids
Ectopic ACTH Dependent causes of Cushings? (1)
Lung Carcinoid
ACTH Independent causes of Cushings? (2)
Adenoma or Carcinoma
ACTH Dependent causes of Cushings?
Cushings Disease/Pit Tumour
Physiological Causes of Cushings (5)
Pregnnacy Glucorticoid Resistance Depression Obesity Diabetes
Diagnosis of Cushings (4)
24 Hour Urinary Free Cortisol
Overnight Dexamethasone Suppression
Plasma ACTH
MRI
What does Urinary Free Cortisol do in Cushings?
Increase
If ACTH Decreases in Plasma ACTH what is the cause of Cushings?
ACTH Independent
If ACTH Increases in Plasma ACTH what is the cause of Cushings?
ACTH Dependent
What treatment can be given for Cushings?
Surgery
Adrenal Hormone Synthesis Inhibitors eg ketoconazole, ecomidate, metyrapone
Destroy Adrenal Cells: Mitotone
What tablet can be given to destroy adrenal cells in cushings?
Mitotone
What adrenal hormone synthesis inhibitors can be given in cushings (3)
Ketoconazole
Ecotmidate
Metyrapone
What 4 Side effects from Glucocorticoid use?
Lipolysis
Gluconeogenesis
Suppressed Immune
Protein Catbaolism
Most Common Cause of Cushings Syndrome/Disease?
Pituitary Tumour
Most Common ACTH Dependent reason for Cushings?
Pituitary Tumour
What should overnight dexamethasone suppression test result be to confirm cushings?
> 50
