Cushing Syndrome: Causes and Symptoms
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Questions and Answers

Cushing Syndrome is caused by the hypersecretion of ______

Cortisol

______ tumor can cause Cushing Syndrome

Pituitary

A symptom of Cushing Syndrome is ______ facies, which is a round face

Moon

Adrenal Insufficiency, also known as ______'s Disease, is caused by the hyposecretion of Cortisol

<p>Addison's</p> Signup and view all the answers

A symptom of Adrenal Insufficiency is ______ skin, which is characterized by hyperpigmentation

<p>Bronzed</p> Signup and view all the answers

During an Adrenal crisis, treatment includes giving ______ foods to replenish electrolytes

<p>Salty</p> Signup and view all the answers

What is the primary effect of amylin on gastric emptying?

<p>Delays gastric emptying</p> Signup and view all the answers

Under which conditions is glucagon secretion stimulated?

<p>When blood glucose levels are low</p> Signup and view all the answers

What is the effect of somatostatin on hormone secretion?

<p>Inhibits hormone secretion</p> Signup and view all the answers

What is the primary function of leptin?

<p>Controls body fat and satiety</p> Signup and view all the answers

What is a hallmark of T2DM related to leptin?

<p>Leptin resistance</p> Signup and view all the answers

Which hormone is responsible for promoting satiety and delaying gastric emptying?

<p>Amylin</p> Signup and view all the answers

What is the effect of glucagon on blood glucose levels?

<p>Increases blood glucose levels</p> Signup and view all the answers

Which hormone inhibits the secretion of insulin, glucagon, and gastrin?

<p>Somatostatin</p> Signup and view all the answers

What is the effect of leptin resistance in diabetes mellitus?

<p>Increased hunger and obesity</p> Signup and view all the answers

Which of the following is NOT a condition that stimulates glucagon secretion?

<p>High blood glucose levels</p> Signup and view all the answers

Which hormone has an opposite effect on blood glucose levels compared to insulin?

<p>Glucagon</p> Signup and view all the answers

What is the net effect on blood glucose levels when somatostatin is secreted?

<p>Decreases blood glucose levels</p> Signup and view all the answers

In diabetes mellitus, which hormone is often deficient, leading to impaired satiety and rapid gastric emptying?

<p>Amylin</p> Signup and view all the answers

Which hormone is secreted in response to stress and protein ingestion, leading to increased blood glucose levels?

<p>Glucagon</p> Signup and view all the answers

What is the primary consequence of leptin resistance in diabetes mellitus?

<p>Excess hunger and obesity</p> Signup and view all the answers

Which hormone has a direct role in regulating glycogenolysis and gluconeogenesis?

<p>Glucagon</p> Signup and view all the answers

What is the primary effect of somatostatin on intestinal glucose absorption?

<p>Decreases glucose absorption</p> Signup and view all the answers

Which hormone is primarily responsible for maintaining a 'full' feeling in healthy individuals?

<p>Leptin</p> Signup and view all the answers

What is the result of leptin resistance in diabetes mellitus?

<p>Increased hunger</p> Signup and view all the answers

Which hormone is often deficient in diabetes mellitus, leading to impaired satiety and rapid gastric emptying?

<p>Amylin</p> Signup and view all the answers

What is the time period that Hemoglobin A1C measures the average amount of glucose attached to hemoglobin in red blood cells?

<p>2-3 months</p> Signup and view all the answers

What is the primary benefit of using Hemoglobin A1C for diabetes management?

<p>It offers a snapshot of average blood glucose control over a longer period of time</p> Signup and view all the answers

What is the typical breathing rate associated with Kussmaul respirations?

<p>Often exceeding 24 breaths per minute</p> Signup and view all the answers

Which of the following symptoms is NOT associated with Kussmaul respirations?

<p>Seizures</p> Signup and view all the answers

What is the primary inspiration phase characteristic of Kussmaul respirations?

<p>Prolonged inspiration phase</p> Signup and view all the answers

What is a common symptom of Hyperthyroidism?

<p>Heat intolerance</p> Signup and view all the answers

Which of the following is a symptom of Thyrotoxicosis?

<p>Nervousness and tremors</p> Signup and view all the answers

What is a characteristic of Exophthalmos?

<p>Fluid buildup behind the eyes</p> Signup and view all the answers

What is a common symptom of Hypothyroidism?

<p>Cold intolerance</p> Signup and view all the answers

What is a severe complication of Hypothyroidism?

<p>Myxedema</p> Signup and view all the answers

What is a characteristic of Hyperthyroidism?

<p>Increased metabolism</p> Signup and view all the answers

What is a symptom of Hypothyroidism?

<p>Fine thin hair or hair loss</p> Signup and view all the answers

Which of the following is a symptom of Hyperthyroidism?

<p>Increased HR and palpitations</p> Signup and view all the answers

Which of the following symptoms is commonly associated with Hyperthyroidism?

<p>Weight loss and nervousness</p> Signup and view all the answers

What is a common symptom of Hypothyroidism?

<p>Dry and coarse hair</p> Signup and view all the answers

Which of the following is a severe complication of Hypothyroidism?

<p>Myxedema</p> Signup and view all the answers

What is a characteristic of Exophthalmos?

<p>Fluid buildup behind the eyes</p> Signup and view all the answers

Which of the following symptoms is NOT associated with Hyperthyroidism?

<p>Cold intolerance</p> Signup and view all the answers

What is a common symptom of Thyrotoxicosis?

<p>Heat intolerance</p> Signup and view all the answers

Which of the following symptoms is commonly associated with Hypothyroidism?

<p>Lethargy</p> Signup and view all the answers

What is a characteristic of Thyroid Eye Disease (TED)?

<p>Fluid buildup behind the eyes</p> Signup and view all the answers

What is a common symptom of Conn Syndrome?

<p>Hypokalemia</p> Signup and view all the answers

What is a physiological effect of cortisol?

<p>Suppresses the inflammatory response</p> Signup and view all the answers

What is a characteristic of androgens?

<p>Stimulates tissue growth and increases blood flow</p> Signup and view all the answers

What is the effect of aldosterone on electrolyte balance?

<p>Decreases potassium levels and increases sodium levels</p> Signup and view all the answers

What is a physiological effect of cortisol on glucose metabolism?

<p>Stimulates gluconeogenesis and glycogenolysis</p> Signup and view all the answers

What is a characteristic of aldosterone's effect on blood pressure?

<p>Increases blood pressure by increasing sodium reabsorption</p> Signup and view all the answers

What is a common symptom of pheochromocytoma?

<p>Profuse sweating</p> Signup and view all the answers

Which of the following is a pressure problem associated with pheochromocytoma?

<p>Hypertension</p> Signup and view all the answers

What is a common palpitation associated with pheochromocytoma?

<p>Tachycardia</p> Signup and view all the answers

Why should the abdomen not be palpated in a patient with pheochromocytoma?

<p>To avoid stimulating the tumor</p> Signup and view all the answers

What is a characteristic of pheochromocytoma?

<p>Benign adrenal medulla tumor</p> Signup and view all the answers

What is a common symptom of pheochromocytoma that is related to vasoconstriction?

<p>Profuse sweating</p> Signup and view all the answers

Why should the abdomen not be palpated in a patient with pheochromocytoma?

<p>To avoid inducing a hypertensive crisis</p> Signup and view all the answers

What is the cause of excessive hypertension in pheochromocytoma?

<p>Overproduction of catecholamines</p> Signup and view all the answers

What is a common symptom of pheochromocytoma that is related to pressure problems?

<p>Headache</p> Signup and view all the answers

What is a common symptom of pheochromocytoma that is related to excessive catecholamine production?

<p>Pounding palpitation</p> Signup and view all the answers

Study Notes

Cushing Syndrome: Hypersecretion of Cortisol

  • Caused by increase in ACTH, exogenous steroids, or adrenal tumor
  • Characteristics:
    • Hyperglycemia
    • Infection and delayed wound healing
    • Osteoporosis
    • Peptic Ulcer Disease (PUD)
    • Hypertension (HTN)
    • Thin, fragile skin
    • Stretch marks
    • Moon facies: round face
    • Buffalo hump: hump on back
    • Truncal obesity
    • Muscle wasting
    • Thin extremities
    • Hirsutism: abnormal facial hair growth in women

Adrenal Insufficiency (Addison's Disease): Hyposecretion of Cortisol

  • Caused by autoimmune destruction of cortex, tumor, TB, trauma, decrease in ACTH, or abrupt withdrawal of steroid medications
  • Characteristics:
    • Bronzed skin due to hyperpigmentation (MSH)
    • Hyponatremia
    • Hyperkalemia
    • Hypoglycemia
    • Muscle weakness
    • Confusion
    • Electrolyte imbalances
    • Decreased urine output
    • Amenoria
    • Sparse hair growth

Adrenal Crisis

  • Characterized by low cortisol, leading to hypoglycemia, and low aldosterone, leading to hyponatremia
  • Symptoms:
    • Coma or death
    • Dehydration
    • Hypotension
    • Hyperkalemia
    • Circulatory collapse and shock
  • Treatment:
    • Steroids
    • Taper off steroids
    • Give salty foods (carbs, sugars, salt)
    • ADD Some Salt: ADD-i-Son'S
    • Soup is salty!

Pancreatic Hormones

  • Amylin: a peptide hormone co-secreted with insulin, usually deficient in diabetes mellitus (DM), delays gastric emptying, and promotes satiety (feeling of fullness).

Glucagon

  • Has an opposite effect to insulin, increasing blood glucose (BG) levels.
  • Stimulates glycogenolysis and gluconeogenesis.
  • Secreted when: • BG levels are low. • Protein is ingested. • Under stress.

Somatostatin

  • Inhibits hormone secretion of: insulin, glucagon, growth hormone (GH), thyroid-stimulating hormone (TSH), and gastrin.
  • Reduces intestinal glucose absorption, lowering BG levels.

Leptin

  • A peptide hormone found in pancreatic beta cells and adipose tissues.
  • Regulates body fat, maintaining a "full" feeling.
  • In DM, leptin resistance leads to: • Increased hunger. • Obesity. • Excess insulin production.

Hallmarks of Type 2 Diabetes Mellitus (T2DM)

  • Resistance to leptin.

Pancreatic Hormones

  • Amylin: a peptide hormone co-secreted with insulin, usually deficient in diabetes mellitus (DM), delays gastric emptying, and promotes satiety (feeling of fullness).

Glucagon

  • Has an opposite effect to insulin, increasing blood glucose (BG) levels.
  • Stimulates glycogenolysis and gluconeogenesis.
  • Secreted when: • BG levels are low. • Protein is ingested. • Under stress.

Somatostatin

  • Inhibits hormone secretion of: insulin, glucagon, growth hormone (GH), thyroid-stimulating hormone (TSH), and gastrin.
  • Reduces intestinal glucose absorption, lowering BG levels.

Leptin

  • A peptide hormone found in pancreatic beta cells and adipose tissues.
  • Regulates body fat, maintaining a "full" feeling.
  • In DM, leptin resistance leads to: • Increased hunger. • Obesity. • Excess insulin production.

Hallmarks of Type 2 Diabetes Mellitus (T2DM)

  • Resistance to leptin.

Pancreatic Hormones

  • Amylin: a peptide hormone co-secreted with insulin, usually deficient in diabetes mellitus (DM), delays gastric emptying, and promotes satiety (feeling of fullness).

Glucagon

  • Has an opposite effect to insulin, increasing blood glucose (BG) levels.
  • Stimulates glycogenolysis and gluconeogenesis.
  • Secreted when: • BG levels are low. • Protein is ingested. • Under stress.

Somatostatin

  • Inhibits hormone secretion of: insulin, glucagon, growth hormone (GH), thyroid-stimulating hormone (TSH), and gastrin.
  • Reduces intestinal glucose absorption, lowering BG levels.

Leptin

  • A peptide hormone found in pancreatic beta cells and adipose tissues.
  • Regulates body fat, maintaining a "full" feeling.
  • In DM, leptin resistance leads to: • Increased hunger. • Obesity. • Excess insulin production.

Hallmarks of Type 2 Diabetes Mellitus (T2DM)

  • Resistance to leptin.

Pancreatic Hormones

  • Amylin: a peptide hormone co-secreted with insulin, usually deficient in diabetes mellitus (DM), delays gastric emptying, and promotes satiety (feeling of fullness).

Glucagon

  • Has an opposite effect to insulin, increasing blood glucose (BG) levels.
  • Stimulates glycogenolysis and gluconeogenesis.
  • Secreted when: • BG levels are low. • Protein is ingested. • Under stress.

Somatostatin

  • Inhibits hormone secretion of: insulin, glucagon, growth hormone (GH), thyroid-stimulating hormone (TSH), and gastrin.
  • Reduces intestinal glucose absorption, lowering BG levels.

Leptin

  • A peptide hormone found in pancreatic beta cells and adipose tissues.
  • Regulates body fat, maintaining a "full" feeling.
  • In DM, leptin resistance leads to: • Increased hunger. • Obesity. • Excess insulin production.

Hallmarks of Type 2 Diabetes Mellitus (T2DM)

  • Resistance to leptin.

Hemoglobin A1C: A1C Target Ranges

What is Hemoglobin A1C?

  • Hemoglobin A1C (HbA1C) measures average blood glucose levels over the past 2-3 months by detecting glucose attached to hemoglobin in red blood cells.
  • It serves as an indicator of average blood glucose control in people with diabetes.

A1C Target Ranges

  • The American Diabetes Association (ADA) recommends specific A1C target ranges for diabetes management.
  • The general target A1C range is set by the ADA for diabetes patients.

Kussmaul Respirations

  • Characterized by deep, rapid breaths.

Respiratory Symptoms

  • Deep breathing: louder than usual.
  • Rapid breathing: exceeds 24 breaths per minute.
  • Sustained inspiration: longer time spent inhaling.

Other Symptoms

  • Tachycardia (rapid heart rate).
  • Anxiety or restlessness.
  • Confusion or altered mental status.
  • Nausea and vomiting.
  • Headache.
  • Fatigue or lethargy.

Associated Conditions

  • Diabetic ketoacidosis (DKA).
  • Metabolic acidosis.
  • Respiratory acidosis.
  • Cardiac disease.
  • Chronic obstructive pulmonary disease (COPD).
  • Pneumonia.
  • Sepsis.

Important Note

  • Kussmaul respirations are a sign of an underlying medical condition, requiring prompt medical attention for diagnosis and treatment.

Hyperthyroidism

  • Characterized by excessive TSH, T3, and T4 levels
  • Common causes:
    • Graves disease (autoimmune), which stimulates the thyroid to produce too much T4
    • Thyroid nodule (tumor) - adenoma
    • Pituitary tumor (very rare), which causes high TSH levels leading to excessive T4 production
  • Manifestations (FAST):
    • Goiter
    • Exophthalmos (TED - thyroid eye disease)
    • Increased metabolism
    • Heat intolerance, sweating, and flushed warm skin
    • Nervousness, tremors, mood swings, and insomnia
    • Weight loss
    • Increased heart rate, palpitations, and arrhythmias
    • Fine thin hair or hair loss
    • Fragile nails
    • Increase in skin pigmentation
    • Thyrotoxicosis (extreme/crisis, also known as "thyroid storm"), which can be life-threatening

Hypothyroidism

  • Characterized by low T3/T4 levels and elevated TSH
  • Two major causes:
    • Primary hypothyroidism:
      • Altered thyroid gland
      • Hashimoto's thyroiditis (autoimmune, which destroys the thyroid)
      • Thyroidectomy
    • Secondary hypothyroidism:
      • Normal thyroid gland, but not releasing T3/4
      • Low TRH from hypothalamus causing low TSH from anterior pituitary
      • Iodine deficiency
  • Manifestations (S L O W):
    • Decreased metabolism
    • Cold intolerance
    • Bradycardia, increasing the risk of congestive heart failure
    • Atherosclerosis, increasing the risk of coronary artery disease
    • Lethargy, fatigue, weakness, and mental slowing
    • Anemia due to lack of erythropoiesis to stimulate RBC production
    • Constipation
    • Anorexia
    • Weight gain
    • Puffy face and extremities
    • Dry/coarse hair, alopecia, and loss of 1/3 eyebrow hair
    • Brittle nails
    • Yellow skin color
    • Infertility (possibility)
  • Severe hypothyroidism:
    • Myxedema - excessively low BMR, which carries the risk of circulatory collapse
    • Important note: do not quickly rewarm patients, as it causes vasodilation and can lead to a drop in blood pressure
  • Congenital Hypothyroidism:
    • Formerly known as "Cretinism"
    • Causes mental retardation
    • Tested at birth

Hyperthyroidism

  • Characterized by excessive TSH, T3, and T4 levels
  • Common causes:
    • Graves disease (autoimmune), which stimulates the thyroid to produce too much T4
    • Thyroid nodule (tumor) - adenoma
    • Pituitary tumor (very rare), which causes high TSH levels leading to excessive T4 production
  • Manifestations (FAST):
    • Goiter
    • Exophthalmos (TED - thyroid eye disease)
    • Increased metabolism
    • Heat intolerance, sweating, and flushed warm skin
    • Nervousness, tremors, mood swings, and insomnia
    • Weight loss
    • Increased heart rate, palpitations, and arrhythmias
    • Fine thin hair or hair loss
    • Fragile nails
    • Increase in skin pigmentation
    • Thyrotoxicosis (extreme/crisis, also known as "thyroid storm"), which can be life-threatening

Hypothyroidism

  • Characterized by low T3/T4 levels and elevated TSH
  • Two major causes:
    • Primary hypothyroidism:
      • Altered thyroid gland
      • Hashimoto's thyroiditis (autoimmune, which destroys the thyroid)
      • Thyroidectomy
    • Secondary hypothyroidism:
      • Normal thyroid gland, but not releasing T3/4
      • Low TRH from hypothalamus causing low TSH from anterior pituitary
      • Iodine deficiency
  • Manifestations (S L O W):
    • Decreased metabolism
    • Cold intolerance
    • Bradycardia, increasing the risk of congestive heart failure
    • Atherosclerosis, increasing the risk of coronary artery disease
    • Lethargy, fatigue, weakness, and mental slowing
    • Anemia due to lack of erythropoiesis to stimulate RBC production
    • Constipation
    • Anorexia
    • Weight gain
    • Puffy face and extremities
    • Dry/coarse hair, alopecia, and loss of 1/3 eyebrow hair
    • Brittle nails
    • Yellow skin color
    • Infertility (possibility)
  • Severe hypothyroidism:
    • Myxedema - excessively low BMR, which carries the risk of circulatory collapse
    • Important note: do not quickly rewarm patients, as it causes vasodilation and can lead to a drop in blood pressure
  • Congenital Hypothyroidism:
    • Formerly known as "Cretinism"
    • Causes mental retardation
    • Tested at birth

Mineralocorticoids

  • Aldosterone is a type of mineralocorticoid that helps regulate salt and water balance
  • Released in response to the Renin-Angiotensin-Aldosterone (RAA) system
  • Functions: reabsorbs sodium and water, excretes potassium, and increases blood pressure

Conn Syndrome

  • Also known as primary aldosteronism
  • Characterized by excess aldosterone production
  • Symptoms: hypertension and hypernatremia

Glucocorticoids

  • Cortisol is a type of glucocorticoid involved in glucose metabolism
  • Released in response to ACTH (Adrenocorticotropic Hormone) from the anterior pituitary
  • Functions:
    • Helps the body respond to stress
    • Stimulates gluconeogenesis, providing glucose to the brain
    • Mobilizes free fatty acids for energy production
    • Suppresses inflammatory and immune responses
    • Increases serum calcium levels by decreasing calcium absorption in bones, reducing heartburn

Androgens

  • Testosterone is a type of androgen involved in tissue growth and development
  • Produced in testes in males and ovaries in females
  • Functions:
    • Stimulates tissue growth and blood flow
    • Develops male secondary characteristics, such as dark hair and a low voice

Pheochromocytoma - Genetic

  • A benign tumor located in the adrenal medulla that produces excessive amounts of catecholamines
  • Characterized by excessive hypertension (HTN) due to overproduction of catecholamines
  • Common symptoms include:
    • Pressure problems
    • Pounding headaches (HA)
    • Palpitations
    • Vasoconstrictions
    • Profuse sweating
  • Important note: Avoid palpating the abdomen in patients with this condition

Pheochromocytoma - Genetic

  • A benign tumor located in the adrenal medulla that produces excessive amounts of catecholamines
  • Characterized by excessive hypertension (HTN) due to overproduction of catecholamines
  • Common symptoms include:
    • Pressure problems
    • Pounding headaches (HA)
    • Palpitations
    • Vasoconstrictions
    • Profuse sweating
  • Important note: Avoid palpating the abdomen in patients with this condition

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This quiz covers the causes and symptoms of Cushing Syndrome, a disorder caused by excess cortisol in the body. Learn about the effects of hypersecretion of cortisol on the body.

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