Endo- Cushing Syndrome Flashcards
Which ion level is low in ectopic ACTH secretion
K+
What are the investigations for Cushing syndrome
- Overnight low-dose dexamethasone suppression test
- 24 hour urinary free cortisol measurement
- 48 hr low-dose dexamethasone test
- Circadian rhythm
- late night salivary cortisol

For overnight low dose dexamethasone suppression test, which value suggest Cushing syndrome
Cortisol level greater than 5 µg/ dl 
What is the level free Cortisol in a person with Cushing’s syndrome in 24 hour urinary free cortisol measurement
300 to 1000 µg /24 hours
What are the symptoms and signs of Cushing syndrome
- Weight gain
- muscle weakness
- obesity
- backache
- sexual disturbances
- depression or psychosis
- hirsutism
- hypertension
- plethora
- acne and skin infections
- skin pigmentation
- increased risk of opportunistic infections
- Moon face, buffalo hump, accumulation of fat in trunkal area
How is Cushing disease different from Cushing syndrome
Cushing disease is excessive corticosteroid secretion due to increased ACTH as a result of primary adenoma
What are the complications of Cushing syndrome
- Hypertension
- DM
- increased risk of infection
- compression fractures of osteoporotic spine
- aseptic necrosis of femoral head
- renal stones
- psychosis
- Nelson’s syndrome
What is Nelson’s syndrome
A complication developed in Cushing syndrome. Following bilateral adrenalectomy , a pituitary adenoma may in large progressively causing local destruction [visual field impairment] and hyper pigmentation
What is the management of Cushing disease
- Transsphenoidal surgery
- bilateral laparoscopic adrenalectomy
- radio therapy
- medical treatment - ketoconazole 20 mg six hourly 
If plasma ACTH is low what is the source of Cushing syndrome
Adrenal gland
If plasma ACTH is normal or high what is the source of Cushing syndrome
- Pituitary ACTH producing tumour
- ectopic ACTH production
