Cushiong's Syndrome vs. Addisons Disease

Question 1

Cushing’s syndrome causes

Answer 1

• Too much ACTH adrenocorticotropic hormone

adrenal tumors

chronic admin of steroid
- transplant
- autoimmune
- COPD

Question 2

s/s of Cushing’s syndrome

Answer 2

• Moon face with buffalo hump
• hypertension- due to vaso constriction
• frequent infections (poor wound healing)
• hursutism

Question 3

labs/diagnostics of Cushing’s syndrome

Answer 3

• hyperglycemia
• hypernatremia
• hypokalemia

cortisol in am
dexamthesone suppresion test to differentiate cause

Question 4

management of Cushing’s

Answer 4

• steroids
• stop or decrease

transphenoidal resection of pituitary adenoma

removal of adrenal tumor

manage electrolyte imbalance

Question 5

Addison’s disease causes

Answer 5

• not enough cortisol, androgens, and aldosterone

metastatic cancer
pituitary failure resulting in decreased ACTH production

Question 6

androgen + aldosteron

Answer 6

mineralocorticoid

Question 7

s/s of addison’s dx

Answer 7

• hyperpigmentation in skin creases (bronzed look)
• orthostasis and hypotension

Question 8

labs/ diagnostics in addisons dx

Answer 8

• hypoglycemia
• hyponatremia
• hyperkalemia

Question 9

plasma cortisol will be ______ in addisons disease

Answer 9

LOW
cortison < 5 mcg/dl ) 0800

Question 10

Cosyntropin test does what

Answer 10

measures how well your adrenal glands respond to adrenocorticotropic hormone (ACTH).

used in addisons disease

Question 11

management of Addison’s disease

Answer 11

glucocorticoid and mineralocorticoid replacement
- Hydrocortisone
- Fludrocortisone acetate (Florinef)

Inpatient
Hydrocortisone IV 100-300 mg IV initially with NS

replace volume with D5NS at 500 cc/hr x 4 hrs