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7 Cards in this Set
- Front
- Back
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What is Cushing's Syndrome? |
Clinical State due to:
(1) Chronic Cortisol Excess (2) Loss of Circadian Rhythm (3) Loss of Central Negative Feedback |
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List the Signs of Cushing's Syndrome.
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- Central Obesity - Purple Abdominal Striae
- Plethoric Moon Face - Buffalo Hump - Supraclavicular Fat Distibution
- Raised Blood Pressure - Raised Blood Glucose
- Bruising - Skin and Muscle Atrophy - Prone to Infection - Poor Healing
- T2DM - Osteoporosis |
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List the Symptoms of Cushing's Syndrome. |
- Obesity - Difficulty with Weight Loss - Acne
- Depression - Psychosis - Irritability - Lethary and Fatigue
- Erectle Dysfunction - Oligomenorrhoea or Amenorrhoea - Subfertility - Hirsutism - Virilization in Women
- Proximal Muscle Weakness
- Recurrent Achillies Tendon Rupture |
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List the ACTH Dependant Causes of Cushing's Syndrome.
What Percentage of Cushing's Syndrome Cases are due to ACTH Dependant Pathology? |
ACTH Dependant (80% of Cases):
(1) Cushing's Disease
(2) Ectopic ACTH Secretion
Rare: (3) Ectopic CRH Secretion |
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What is Cushing's Disease? |
Bilateral Adrenal Hyperplasia due to a
Usually it is a Microadenoma. |
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List the ACTH Independant Causes of Cushing's Syndrome.
What Percentage of Cushing's Syndrome Cases are due to ACTH Independant Pathology? |
ACTH Independant (20% of Cases):
(1) Iatrogenic from PO Steroids
(2) Adrenal Adenoma or Carcinoma
(3) Adrenal Nodular Hyperplasia
Rare: (4) McCune Albright Syndrome (5) Carney Complex |
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Describe the Investigations for Cushing's Syndrome.
TBC |
FIRST-LINE: 12 Hour Dexamethasone Supression Test Performed at Night as an Outpatient. Administer Dexamethasone 1mg PO at Night; do Serum Cortisol at 8AM. If there is NO Pathology then there will be Negative Feedback and thus Decreased ACTH and thus Decreased Cortisol. Serum Cortisol < 50 nmol/L is Normal.
In Cushing's there is NO Supression and therefore Serum Cortisol > 50 nmol/L.
Performed as an Outpatient. Administer Dexamethosone 0.5mg QDS for 2/7. Measure Cortisol at 0 and 48 Hours. If there is NO Pathology then there will be Negative Feedback and thus Decreased ACTH and thus Decreased Cortisol. Serum Cortisol < 50 nmol/L is Normal.
In Cushing's there is NO Supression and therefore Serum Cortisol > 50 nmol/L.
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