Cushing syndrome and disease

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Hypercortisolism

Cushing's syndrome may be

Exogenous or endogenous

Most common form of exogenous

Corticosteroid drugs used to treat other diseases

Cushing disease is caused by

Excess secretion of ACTH by the pituitary, often result in a small pituitary adenoma

The major cause of endogenous Cushing's syndrome

Cushing's disease

Cushing disease

Most common pre-menopausal women

Other causes of Cushings syndrome

Adrenocortical tumors and nonpitutary ACTH-producing tumors

Hypercortisolism may present as

obesity, hypertension, and diabetes mellitus

Clinical presentation

Obesity is centripetal, and extremities appear wasted

Fat deposits also causes a characteristic

Buffalo hump moon facies, and supraclavicular pads

The most specific signs are

proximal muscle weakness and pigmented stria more than 1cm wide

Patients may present with

back ache and headache

Common presenting symptoms

oligomenorrhea amenorrhea erectile dysfunction

Disorders calcium metabolism may cause

osteoporosis vertebral fracture hypercalciuria and kidney stones

Other symptoms

wound healing acne easy bruisability and superficial skin infections

Psych symptoms

emotional lability to psychosis

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