30. Hypercortisim Flashcards
(15 cards)
What is Cushing’s syndrome characterized by?
Excessive levels of cortisol.
Normal levels in the morning 10 to 20 micrograms per deciliter later during afternoon it can drop to 3-10
What is the most common cause of Cushing’s syndrome?
Iatrogenic Cushing syndrome caused by prescribed corticosteroids.
What leads to bilateral adrenal hyperplasia in Cushing’s disease?
Adrenocorticotropic Hormone (ACTH)-secreting pituitary adenoma.
What percentage of Cushing’s syndrome cases are due to adrenal adenomas and carcinomas?
10-15%.
What is ectopic ACTH production often associated with?
Small cell lung carcinomas.
What are some clinical features of Cushing’s syndrome?
Central obesity, hirsutism, moon facies, fat accumulation at the neck, purple abdominal striae, lanugo hair, acne, easy bruising, hypertension, decreased glucose tolerance, hypogonadism, masculinization in females, musculoskeletal issues, and mood disorders.
What is the initial screening test for Cushing’s syndrome?
Overnight low-dose dexamethasone suppression test.
What cortisol level at 8 am suggests Cushing syndrome?
Values above 5 μg/dL.
What does a low ACTH level suggest when Cushing syndrome is established?
Adrenal origin.
What does a high ACTH level indicate?
Pituitary or ectopic ACTH production.
What is the treatment for iatrogenic Cushing syndrome?
Gradual glucocorticoid tapering.
What is the treatment for pituitary Cushing syndrome?
Transsphenoidal adenoma removal.
What is the treatment for adrenal adenoma or carcinoma?
Adrenalectomy.
What is the recommended treatment for residual or recurrent pituitary adenoma?
Radiation therapy.
What therapies are used for metastatic adrenal carcinoma?
Chemotherapy or targeted therapy.
