IT2 Exam 5 Sumida

influence electrolyte volume balance (Sodium and potassium)

• Mineralocorticoids (aldosterone)

• Glucocorticoids (cortisol)

• Sex Hormones (dehydroepiandrosterone)

glucose, protein, lipid metabolism and adaptation to stress)

• Mineralocorticoids (aldosterone)

• Glucocorticoids (cortisol)

• Sex Hormones (dehydroepiandrosterone)

androgen (most abundant and physiologically important)

• Mineralocorticoids (aldosterone)

• Glucocorticoids (cortisol)

• Sex Hormones (dehydroepiandrosterone)

Excess glucocorticoids produced in response to overproduction of ACTH (Cushing Disease, or ectopic ACTH secreting tumors - pancreas, thyroid, lung)

• ACTH Dependent

• ACTH Independent

Abnormal adrenocortical tissue produce glucocorticoid regardless of ACTH stimulation (Adrenal Adenoma)

• ACTH Dependent

• ACTH Independent

How can one establish the presence of hypercortisolism?

• 24-hour UFC (urinary free cortisol)

• Late-night salivary cortisol concentration

• Dexamethasone suppression test

• INR

• Chest xray

How can one establish the etiology of a cortisol issue?

• 24-hour UFC (urinary free cortisol)

• Late-night salivary cortisol concentration

• Chest Xray

• Plasma ACTH

• MRI

How does one acquire Cushing Syndrome?

• Inhaled glucocorticoids

• Intra-articular glucocorticoids

• Topical glucocorticoids

• Iatrogenic (exogenous)

What are clinical signs of Cushing Syndrome?

• Moon face

• Buffalo hump

• Muscle weakness and Myopathy

• Weight loss

• Facial thinning

What are treatment options for Cushing Syndrome?

• AOC surgical resection

• Medication therapy