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cushing syndrome - Coggle Diagram
cushing syndrome
how to make diagnosis
anamnesis
in patients with cushing syndrome usually generally with complaints of moon face and buffalo hump and also facial acne. and ask about additional complaints such as excessive fatigue, weight gain even though eating as usual. and also ask about complaints of previous illnesses and family illnesses
physical examination
vital sign: increased pulse rate, and hypertension
head to toe
in patients with Cushing's syndrome is body obesity (truncal obesity) with extremities that appear smaller or thinner. The buildup of adipose tissue on the face causes moon face and adipose tissue deposition on the upper back and in between the two scapulae which causes the appearance of the buffalo hump. In addition to the Moon Face, the face of a Cushing's Syndrome sufferer also looks redder and in women can grow hair (hirsutism).
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risk factor, clinical menifestation, etiology
clinical manifastations
a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes
risk factors
Pituitary adenomas (Cushing's disease) account for more than 70 percent of cases in adults and about 60-70 percent of cases in children and adolescents. Cushing's syndrome most commonly affects adults ages 20-50 and is more prevalent in females, accounting for about 70 percent of all cases.
high blood pressure, serious infections, fractures due to osteoporosis, kidney stones
etiology
An abnormality of the adrenal glands, such as an adrenal tumor, may cause Cushing's syndrome
physiology adrenal gland
The hypothalamus produces corticotropin-releasing hormone (CRH) that stimulates the pituitary gland to secrete adrenocorticotropin hormone (ACTH). ACTH then stimulates the adrenal glands to make and release cortisol hormones into the blood.
adrenal glands are controlled in part by hypothalamus and pituitary gland. The hypothalamus, a small area of brain involved in hormonal regulation, produces corticotropin-releasing hormone (CRH) and antidiuretic hormone (ADH, or vasopressin)
education & prognosis
education
Eat a healthy diet. Choose a variety of healthy foods that are high in protein and calcium. This can help prevent muscle and bone loss caused by high cortisol levels.
For those with Cushing's syndrome, lowering cortisol can be at least helped by switching to a whole foods, anti-inflammatory foods diet, reducing stress levels, and changing the level of exercise and physical activity.
prognosis
The prognosis for those with Cushing's syndrome varies depending on the cause of the disease. Most cases of Cushing's syndrome can be cured. Many individuals with Cushing's syndrome show significant improvement with treatment, although some may find recovery complicated by various aspects of the causative illness
differential diagnosis
Cushing disease (is an endocrine disorder characterized by increased production of adrenocorticotropic hormone (ACTH) from the anterior pituitary, which causes excess cortisol release from the adrenal glands)
Polycystic ovary syndrome (PCOS) is a disease when the ovum or egg cells in women do not develop normally due to hormonal imbalance. Genetic factors are associated by experts as one of the causes. This genetic factor is associated with the occurrence of high androgen increases in women with PCOS. Unbalanced hormones can cause abnormal hair growth and acne. In addition to these conditions, women also cannot release ovum from the ovaries every menstruation.
management
farmacological
Medications to control excessive production of cortisol at the adrenal gland include ketoconazole, mitotane (Lysodren) and metyrapone (Metopirone). Mifepristone (Korlym, Mifeprex) is approved for people with Cushing syndrome who have type 2 diabetes or glucose intolerance
non-pharmacological
Surgical removal of a pituitary tumor will permanently cure Cushing's syndrome in 60-70% of people. However, removing all or part of the pituitary gland may interfere with ovulation and sperm production. These individuals usually receive lifelong hormone replacement therapy.
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