Cushing Syndrome Case Study
Terms in this set (8)
What is the relationship between cortisol and ACTH in a non-disease state?
ACTH stimulates cortisol release, cortisol inhibits ACTH release
CS is often associated with an abnormally high level of cortisol within the blood. This could be caused by:
High levels of ACTH
What could be a cause of CS?
Cortisol secreting tumor in the adrenal cortex, hyperpituitarism of the anterior pituitary gland, or ruse of prednisone (cortisol-like steroid medication)
Your patient has a form of CS and received the following blood test results: CRH levels are very low, ACTH levels are very high, cortisol levels are very high. Suggests a hormone secreting tumor. Where is the tumor located?
Anterior pituitary gland
What would the blood work look like for a person with CS after taking high doses of corticosteroids for their asthma? (CRH, ACTH, Cortisol levels)
Low CRH, Low ACTH, High cortisol
Cortisol is not only regulated through endocrine pathway, it is also a hormone that is regulated by our circadian rhythm. Cortisol levels tend to be highest in the morning, fluctuate during the day, and are at their lowest in the evening. An indicator of CS can be seen when testing cortisol levels at night and comparing them to nighttime cortisol levels from a health person. Why are cortisol levels tested at night?
Cortisol is associated with alertness, and a decrease in cortisol level during the night facilitates sleep. A CS patient will have consistently high cortisol levels at night
Typically, bedtime is 2-4 hours after eating, so the food the subjects ingested will not cause dramatic cortisol fluctuations that may interfere with accurate results
CS patients will often have many of the same symptoms as those suffering from Diabetes Mellitus, a condition where the body's resistance to insulin increases and causes the blood sugar levels to rise. Cortisol causes blood sugar to rise, while insulin has the opposite effect. What relationship does cortisol and insulin have with each other with regards to blood sugar in a non-disease state, and what would one expect in a patient with both diabetes and CS?
They work in opposition to each other. Blood sugar will often be far higher than the normal range
Increases in cortisol can also lead to changes in BP. How does it do so?
Cortisol is a vasoconstrictor and also increases blood sugar through the breakdown of stored nutrients. The increase of blood glucose causes diffusion of water into the bloodstream to facilitate equilibrium. Increased blood volume and increased vasoconstriction lead to high BP