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Questions and Answers
What is the characteristic appearance of a patient with Cushing's syndrome?
What is the characteristic appearance of a patient with Cushing's syndrome?
What is a common skin manifestation of Cushing's syndrome?
What is a common skin manifestation of Cushing's syndrome?
What is the purpose of the low-dose dexamethasone suppression test in diagnosing Cushing's syndrome?
What is the purpose of the low-dose dexamethasone suppression test in diagnosing Cushing's syndrome?
What is the next step in diagnosing Cushing's syndrome after a low-dose dexamethasone suppression test?
What is the next step in diagnosing Cushing's syndrome after a low-dose dexamethasone suppression test?
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What does a low ACTH level indicate in a patient with Cushing's syndrome?
What does a low ACTH level indicate in a patient with Cushing's syndrome?
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What is the purpose of the CRH stimulation test in diagnosing Cushing's syndrome?
What is the purpose of the CRH stimulation test in diagnosing Cushing's syndrome?
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What is the purpose of bilateral inferior petrosal sinus sampling in diagnosing Cushing's syndrome?
What is the purpose of bilateral inferior petrosal sinus sampling in diagnosing Cushing's syndrome?
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What is a common endocrine manifestation of Cushing's syndrome?
What is a common endocrine manifestation of Cushing's syndrome?
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What is the most common cause of Cushing's syndrome?
What is the most common cause of Cushing's syndrome?
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What is the best treatment for pituitary Cushing's syndrome?
What is the best treatment for pituitary Cushing's syndrome?
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What is the result of excess cortisol on carbohydrate metabolism?
What is the result of excess cortisol on carbohydrate metabolism?
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What is the alternative treatment for pituitary Cushing's syndrome when the adenoma is small?
What is the alternative treatment for pituitary Cushing's syndrome when the adenoma is small?
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Which of the following is NOT a consequence of Cushing's syndrome?
Which of the following is NOT a consequence of Cushing's syndrome?
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What is the effect of cortisol on protein metabolism?
What is the effect of cortisol on protein metabolism?
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What is the treatment for adrenal Cushing's syndrome?
What is the treatment for adrenal Cushing's syndrome?
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Which of the following is a characteristic of Cushing's disease?
Which of the following is a characteristic of Cushing's disease?
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Why is postoperative administration of cortisol necessary in Adrenal Cushing's syndrome?
Why is postoperative administration of cortisol necessary in Adrenal Cushing's syndrome?
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What is the effect of cortisol on water and electrolyte balance?
What is the effect of cortisol on water and electrolyte balance?
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What is the treatment for ectopic ACTH production?
What is the treatment for ectopic ACTH production?
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What is the usual demographic affected by Cushing's syndrome?
What is the usual demographic affected by Cushing's syndrome?
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What is the main feature of Hyperaldosteronism?
What is the main feature of Hyperaldosteronism?
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Which of the following is a consequence of an adrenal adenoma?
Which of the following is a consequence of an adrenal adenoma?
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What is the cause of Primary Hyperaldosteronism (Conn's syndrome)?
What is the cause of Primary Hyperaldosteronism (Conn's syndrome)?
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What is the treatment for Conn's syndrome?
What is the treatment for Conn's syndrome?
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Study Notes
Cushing's Syndrome
- Characterized by truncal obesity, moon face, and limb slimness, giving a "lemon on matchsticks" appearance
- Features protein catabolism, muscle weakness, thinning of skin, abdominal striae, and poor wound healing
- Associated with diabetes, hypertension, amenorrhea, and emotional lability
- Other features include increased capillary fragility, purpura, osteoporosis, acne, hirsutism, and loss of libido
Investigations
- Diurnal variation of cortisol levels is lost in Cushing's syndrome
- Radioimmunoassay of serum cortisol level is used for diagnosis
- Low-dose dexamethasone suppression test is used to confirm the diagnosis
- ACTH level is measured to determine the cause (pituitary or adrenal)
- High-dose dexamethasone test, CRH stimulation test, and bilateral inferior petrosal sinus sampling are used to distinguish between pituitary and ectopic sources
Treatment
- Pituitary Cushing's syndrome: microsurgical excision of the adenoma through the transsphenoidal route
- Adrenal Cushing's syndrome: adrenalectomy of the affected side
- Ectopic ACTH production: excision of the bronchial or pancreatic carcinoma, whenever possible
Hyperaldosteronism
- Caused by oversecretion of aldosterone from the adrenal cortex
- Primary hyperaldosteronism (Conn's syndrome) is caused by a functioning adrenal cortical adenoma
- Secondary hyperaldosteronism occurs with liver, renal, and cardiac diseases
- Retains sodium and water, and loses potassium
- Hypertension is the main feature, and rarely progresses to severe hypokalemic alkalosis, muscle weakness, tetany, and paraesthesia
- Diagnosis is suspected with low serum potassium and confirmed by high plasma aldosterone
- Treatment involves surgical excision of the adrenal gland carrying the adenoma, with laparoscopic adrenalectomy being a preferred option
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Description
This quiz covers the common symptoms of Cushing's syndrome, including physical characteristics and health complications. Test your knowledge of this hormonal disorder.
