Questions and Answers
What is the most common cause of hypercortisolism?
Which of the following is NOT a characteristic symptom of Cushing's syndrome?
What is the primary mechanism for endogenous Cushing's syndrome?
Which of the following diagnostic tests is used to screen for Cushing's syndrome?
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Which of the following is NOT a recommended treatment for exogenous Cushing's syndrome?
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Which of the following is a common symptom of endogenous Cushing's syndrome?
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Which of these is a risk factor for developing Cushing's syndrome?
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What is the most common underlying cause of secondary Cushing's syndrome?
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Study Notes
Cushing Syndrome (Hypercortisolism)
Etiology
- Exogenous hypercortisolism: most commonly caused by prolonged glucocorticoid therapy
- Endogenous hypercortisolism: classified into two categories
- Primary: ACTH-independent, often caused by adrenal adenomas
- Secondary: pituitary ACTH production or ectopic ACTH production, often caused by pituitary adenomas or small cell lung cancer
Diagnosis
- Screening test: 24-hour urine cortisol test
- Determine underlying cause: hormone analysis (e.g., serum ACTH levels) and imaging to localize tumor
Treatment
- Exogenous Cushing syndrome: reduce glucocorticoid dosage or consider alternative treatments
- Endogenous causes: tumor resection or drugs to suppress cortisol synthesis if inoperable
Symptoms
- Facial erythema: redness of the face
- Hypertrichosis/hirsutism: excessive hair growth
- Dorsocervical fat pad: fat pad located at the back of the neck
- Acne: breakouts on the skin
- Hypertension: high blood pressure
- Skin atrophy/thinning: thinning of the skin
- Striae: stretch marks on the skin
- Osteoporosis, osteopenia, avascular necrosis of the femoral head: bone loss and thinning
- Muscle atrophy/myopathy: muscle weakness
- Growth delay (children): slower growth rate in children
- Insomnia, mood disorders, psychosis, decreased libido: sleep problems, mood changes, and low sex drive
- Cataract, glaucoma: eye problems
- Moon facies: round, full face
- Peptic ulcers: sores in the stomach or intestines
- Hyperglycemia (may progress to diabetes): high blood sugar
- Central (truncal) obesity: fat deposition in the abdomen
- Hyperpigmentation (if secondary): darkening of the skin
- Virilization, irregular menstrual cycles, amenorrhea: male-like characteristics in women, irregular periods, and absence of periods
- Purpura/ecchymoses: bruising under the skin
- Poor wound healing, immunosuppression: difficulty healing and weakened immune system
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Description
Learn about the etiology and diagnosis of Cushing Syndrome, a hormonal disorder caused by excess cortisol. Understand the difference between exogenous and endogenous causes and how to diagnose the condition.
