Cushing’s syndrome – Quick revision card

Adrenal gland hyperfunction Cortisol made by the central zone or zona fasciculate

Prolonged exposure to high circulating levels of cortisol is Cushing's syndrome

Exogenous - prolonged use of glucocorticoids

Endogenous - excessive cortisol production by adrenal glands - this can be ACTH dependent ( majority 80 % ) or ACTH independent ( due to benign or malignant adrenal tumors )

ACTH secreting pituitary tumors is called Cushing's disease Ectopic ACTH secretion by neoplasms

Cushing's Disease most frequent cause of Cushing's syndrome ACTH ( adrenocorticotrophic hormone ) hypersecretion due to a corticotroph adenoma causing corticol hypersecretion

Cortisol excess - obesity ( centripetal ) facial plethora , rounded face , buffalo hump fatigue , weakness protein wasting ( thin skin , abdominal purple to red and wide cutaneous striae , east bruising , slow healing , muscle wasting ) osteoporosis ( bone wasting leading to fractures ) raised blood pressure depression , mood swings , emotional reactivity loss of libido , erectile dysfunction in men , irregular menstrual cycle , infertility , hyperhidrosis , hirsutism impaired immunity ( repeated infections ) back pain

R/O exogenous sources mild hypokalaemia may be noted due to mineralocorticoid effect of steroids verification of endogenous hyercortisonilism by...