Flashcards in Cortisol Deck (10):
What are the symptoms of Cushing's syndrome?
Buffalo hump, truncal obesity
skin: striae, acne, easy bruising
Necrosis of femoral had
Cushing's disease causes cushing's syndrome how?
ACTH-secreting pituitary adenoma
Rank the most common causes of Cushing's syndrome?
1. Exogeneous corticosteroid use
2. Ectopic ACTH secreting
3. Cushing's disease: ACTH-secreting pituitary adenoma
4. Cortisol-secreting adrenal tumor
What are the effects of cortisol in the body?
Blood pressure: increased by up regulation of alpha receptors on arterioles
Gluconeogenesis, lipolysis, proteolysis increase in effort to increase available energy
Fibroblast activity decreases--striae
Inflammatory and immune responses--inhibits both
Bone formation decreases-osteoporosis
Describe in more detail what cortisol does to decrease inflammation?
inhibits production of leukotrienes and prostaglandins
Describe in more detail what cortisol does to decrease immune response?
inhibits WBC adhesion (get increase WBC count right after admin of corticosteroids)
blocks histamine release from mast cells
blocks IL-2 production
Which 2 conditions can be reactivated w/ corticosteroid use? Why?
decreases IL-2 production
can cause reactivation of TB and candidiasis
What is the only type of Cushing's syndrome where cortisol is suppressed by high dose of dexamethasone?
ACTH-secreting pituitary adenoma-Cushing's dx
How do you differentiate ACTH-secreting ectopic tissue, like small cell lung cancer from Cortisol-secreting adrenal tumor since they both are unresponsive to high levels of dexamethasone?
Small cell lung cancer will have high ACTH
adrenal tumor will have low ACTH