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Cushing's Syndrome Assessment

Cushion with Assess-man
Picmonic
Cushing's syndrome is a condition caused by excessive amounts of the hormone cortisol being produced in the body. Cortisol is a hormone that helps maintain blood glucose levels, protect the body from stress, and suppress inflammation. This hormone is produced by the adrenal glands, which are located on top of the kidneys. The release of the hormone adrenocorticotropic hormone (ACTH) from the pituitary glands located in the brain signal the body to produce cortisol as part of the endocrine system.
11 KEY FACTS
ASSESSMENT
Increased Cortisol Levels
Up-arrow Court-of-Sol

In Cushing’s syndrome, the adrenal glands are signaled to keep making cortisol, thereby increasing normal levels. Manifestations of this condition are related to the increased cortisol levels in the body. This includes obvious changes in physical appearance.

Truncal Obesity
Trunk Fat

Weight gain is the most common symptom in Cushing’s syndrome, particularly in the chest and stomach (truncal obesity). It occurs because cortisol causes fat to be redistributed to these areas, leaving patients with a large middle section, but thin arms and legs.

Purple Abdominal Striae
Purple Abdominal Stripes

Purple marks called striae (stretch marks) often appear on the abdomen due to rapid weight gain, as well as decreased amounts of collagen available.

Buffalo Hump
Buffalo Hump

Fat deposits on the back of the neck and shoulders occurs and is known as a buffalo hump.

Decreased Bone Density
Down-arrow Bone

Excessive amounts of cortisol can lead to decreased bone density causing osteoporosis and back pain. Additionally, muscle wasting may occur, causing weakness, especially in the extremities.

Moon Face
Moon Face

Fat redistribution due to the cortisol effects often lead to a red, puffy, and rounded face; otherwise known as “moon face.”

Thinning Skin
Thin Skin-suit

Excessive amounts of cortisol lead to deficits in collagen level, which subsequently cause thinning of the skin. This makes the skin more easily prone to bruising. Additionally, catabolic processes slow wound healing.

Hyperglycemia
Hiker-Glue-bottle

Hyperglycemia occurs due to the excessive levels of cortisol, which raise blood glucose levels in response to cortisol-induced insulin resistance and glucose intolerance, as well as increased gluconeogenesis by the liver.

Hypertension
Hiker-BP

Sustained elevated blood pressure is often seen in patients with this disease due to sodium and water retention. This leads to hypervolemia and edema formation, thereby causing hypertension.

CONSIDERATIONS
Long Term Glucocorticoid Use
Glue-quarter-on-steroids

The most common cause of Cushing's syndrome is the long-term use of corticosteroids, particularly glucocorticoids. Examples include prednisone, dexamethasone, and prednisolone. They are often used to treat conditions, such as asthma, rheumatoid arthritis, or cancer.

Immunosuppression
Moon-suppressed

It is important to be aware that patients with Cushing's syndrome/disease are often immunosuppressed. This places them at increased risk for infection related to their lowered resistance to stress and suppression of the immune system.

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