cushing's

Question 1

cushing’s syndrome

Answer 1

signs and symptoms after prolonged abnormal cortisol elevation

Question 2

cushing’s disease

Answer 2

pituitary adenoma secretes excessive ACTH

Question 3

cushing’s syndrome features

Answer 3

moon face
central obesity 
abdo striae
buffalo hump 
proximal limb wasting 
htn 
cardiac hypertrophy 
hyperglycaemia (T2DM) 
depression 
easy bruising 
osteoporosis

Question 4

causes of Cushing’s syndrome

Answer 4

exogenous steroids
Cushing’s disease
adrenal adenoma
paraneoplastic cushing’s

Question 5

dexamathasone suppression test

Answer 5

dose of dexamethasone at night –> cortisol and ACTH measured in morning –> does dexamethasone suppress normal AM cortisol spike

do low dose –> if normal cuhsing’s excluded, if abnormal do high dose to differentiate between causes

Question 6

high dose dexamethasone suppresion test results: pituitary adenoma

Answer 6

low cortisol and ACTH

Question 7

high dose dexamethasone suppresion test results: adrenal adenoma

Answer 7

cotrisol normal

ACTH low

Question 8

high dose dexamethasone suppresion test results: ectopic ACTH (paraneoplasitc)

Answer 8

cortisol and ACTH normal

Question 9

Mx

Answer 9

remove underlying cause