USMLE/COMLEX - Step 2 - Cushing's Syndrome

USMLE/COMLEX - Step 2 - Cushing's Syndrome Cushing's syndrome is caused by excessive cortisol production due to various reasons, such as long-term use of corticosteroid medications, pituitary tumors, or adrenal tumors. The excess cortisol leads to increased glucose production, muscle breakdown, fat redistribution, suppressed immune function, osteoporosis, and high blood pressure, among other physiological changes. Weight gain Skin changes High blood pressure Mood changes Increased thirst and urination Menstrual irregularities/fertility problems in women Decreased libido/erectile dysfunction in men Central obesity Proximal muscle weakness Skin changes Hypertension Hyperglycemia Moon face Buffalo hump Purple striae Osteoporosis Menstrual irregularities Decreased libido Depression and anxiety Increased susceptibility to infections A 24-hour urine cortisol test A late-night salivary cortisol test Low-dose dexamethasone suppression test High-dose dexamethasone suppression test ACTH stimulation test Imaging The treatment of Cushing's syndrome depends on the underlying cause of the condition. Sometimes, treatment may not be necessary if the condition is mild or transient. However, if the cause is a tumor, surgery may be required to remove the tumor. Other treatment options for Cushing's syndrome may include: 1. Medications: Drugs such as ketoconazole, metyrapone, or mitotane may block cortisol production or destroy cells that produce cortisol. 2. Radiation therapy: This may be used to shrink tumors that cannot be removed by surgery. 3. Adrenalectomy: If the cause of Cushing's syndrome is an adrenal tumor, surgery to remove the affected adrenal gland may be necessary. 4. Pituitary tumor removal: Surgery to remove a pituitary tumor may be necessary if the tumor is causing Cushing's syndrome. 5. Lifestyle changes: Changes in diet and exercise may help manage some symptoms of Cushing's syndrome, such as weight gain and high blood pressure.