Cushing Syndrome: Causes and Symptoms

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

Addison's Signup and view all the answers

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

Bronzed Signup and view all the answers

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

Salty Signup and view all the answers

What is the primary effect of amylin on gastric emptying?

Delays gastric emptying Signup and view all the answers

Under which conditions is glucagon secretion stimulated?

When blood glucose levels are low Signup and view all the answers

What is the effect of somatostatin on hormone secretion?

Inhibits hormone secretion Signup and view all the answers

What is the primary function of leptin?

Controls body fat and satiety Signup and view all the answers

What is a hallmark of T2DM related to leptin?

Leptin resistance Signup and view all the answers

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

Amylin Signup and view all the answers

What is the effect of glucagon on blood glucose levels?

Increases blood glucose levels Signup and view all the answers

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

Somatostatin Signup and view all the answers

What is the effect of leptin resistance in diabetes mellitus?

Increased hunger and obesity Signup and view all the answers

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

High blood glucose levels Signup and view all the answers

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

Glucagon Signup and view all the answers

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

Decreases blood glucose levels Signup and view all the answers

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

Amylin Signup and view all the answers

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

Glucagon Signup and view all the answers

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

Excess hunger and obesity Signup and view all the answers

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

Glucagon Signup and view all the answers

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

Decreases glucose absorption Signup and view all the answers

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

Leptin Signup and view all the answers

What is the result of leptin resistance in diabetes mellitus?

Increased hunger Signup and view all the answers

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

Amylin 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?

2-3 months Signup and view all the answers

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

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

What is the typical breathing rate associated with Kussmaul respirations?

Often exceeding 24 breaths per minute Signup and view all the answers

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

Seizures Signup and view all the answers

What is the primary inspiration phase characteristic of Kussmaul respirations?

Prolonged inspiration phase Signup and view all the answers

What is a common symptom of Hyperthyroidism?

Heat intolerance Signup and view all the answers

Which of the following is a symptom of Thyrotoxicosis?

Nervousness and tremors Signup and view all the answers

What is a characteristic of Exophthalmos?

Fluid buildup behind the eyes Signup and view all the answers

What is a common symptom of Hypothyroidism?

Cold intolerance Signup and view all the answers

What is a severe complication of Hypothyroidism?

Myxedema Signup and view all the answers

What is a characteristic of Hyperthyroidism?

Increased metabolism Signup and view all the answers

What is a symptom of Hypothyroidism?

Fine thin hair or hair loss Signup and view all the answers

Which of the following is a symptom of Hyperthyroidism?

Increased HR and palpitations Signup and view all the answers

Which of the following symptoms is commonly associated with Hyperthyroidism?

Weight loss and nervousness Signup and view all the answers

What is a common symptom of Hypothyroidism?

Dry and coarse hair Signup and view all the answers

Which of the following is a severe complication of Hypothyroidism?

Myxedema Signup and view all the answers

What is a characteristic of Exophthalmos?

Fluid buildup behind the eyes Signup and view all the answers

Which of the following symptoms is NOT associated with Hyperthyroidism?

Cold intolerance Signup and view all the answers

What is a common symptom of Thyrotoxicosis?

Heat intolerance Signup and view all the answers

Which of the following symptoms is commonly associated with Hypothyroidism?

Lethargy Signup and view all the answers

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

Fluid buildup behind the eyes Signup and view all the answers

What is a common symptom of Conn Syndrome?

Hypokalemia Signup and view all the answers

What is a physiological effect of cortisol?

Suppresses the inflammatory response Signup and view all the answers

What is a characteristic of androgens?

Stimulates tissue growth and increases blood flow Signup and view all the answers

What is the effect of aldosterone on electrolyte balance?

Decreases potassium levels and increases sodium levels Signup and view all the answers

What is a physiological effect of cortisol on glucose metabolism?

Stimulates gluconeogenesis and glycogenolysis Signup and view all the answers

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

Increases blood pressure by increasing sodium reabsorption Signup and view all the answers

What is a common symptom of pheochromocytoma?

Profuse sweating Signup and view all the answers

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

Hypertension Signup and view all the answers

What is a common palpitation associated with pheochromocytoma?

Tachycardia Signup and view all the answers

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

To avoid stimulating the tumor Signup and view all the answers

What is a characteristic of pheochromocytoma?

Benign adrenal medulla tumor Signup and view all the answers

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

Profuse sweating Signup and view all the answers

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

To avoid inducing a hypertensive crisis Signup and view all the answers

What is the cause of excessive hypertension in pheochromocytoma?

Overproduction of catecholamines Signup and view all the answers

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

Headache Signup and view all the answers

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

Pounding palpitation 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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Description

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.