Adrenal disease

Question 1

Causes of Cushing’s syndrome

Answer 1

Exogenous steroids, Adrenal tumour, ACTH producing pituitary tumour, Ectopic ACTH secreting tumour

Question 2

Define Cushing’s disease

Answer 2

ACTH producing pituitary tumour

Question 3

Complications of Cushing’s syndrome

Answer 3

Cardiovascular disease, Osteoporosis, Diabetes, Infertility

Question 4

Symptoms of Cushing’s syndrome

Answer 4

Weight gain, Psychosis, Weakness, Amenorrhoea, Hirsuitism, Impotence, Decreased wound healing

Question 5

Signs of Cushing’s disease

Answer 5

Central obesity, Moon face, Buffalo hump, Easy bruising, Striae, Hypertension

Question 6

Investigations for Cushing’s syndrome

Answer 6

Urine 24hr cortisol, Serum ACTH, CRH stimulation test, CT/MRI

Question 7

Management of Cushing’s syndrome

Answer 7

Conservative: Stop exogenous steroids
Medical: Metyrapone, Ketoconazole
Surgical: Adrenalectomy, Transsphenoidal resection, Tumour removal

Question 8

Causes of adrenal insufficiency

Answer 8

Addison’s disease, TB, Metasteses, Steroid withdrawal

Question 9

Symptoms of adrenal insufficiency

Answer 9

Weight loss, Tiredness, Depression, Psychosis, Nausea, Vomiting, Diarrhoea, Constipation, Abdominal pain, Myalgia, Syncope, Coma

Question 10

Signs of adrenal insufficiency

Answer 10

Postural hypotension, Hyperpigmentation, Vitiligo

Question 11

Investigations for adrenal insufficiency

Answer 11

Bloods: U+Es, Glucose

Synacthen test

Question 12

Blood findings with adrenal insufficiency

Answer 12

U+Es: Raised K, Low Na

Low glucose

Question 13

Management of adrenal insufficiency

Answer 13

Hydrocortisone