Rapid Review: Cushing’s Syndrome

July 27, 2017
Reviewed By: Amy Rontal
Cushing's syndrome

Cushing’s Syndrome

  • Patient will be complaining of amenorrhea, central obesity, depressive symptoms, and easy bruising
  • PE will show purple striae, “moon face” (facial adiposity), “buffalo hump” (increased adipose tissue in the neck and upper back), and hypertension
  • Diagnosis is made by 24-hr urine cortisol and testing ACTH levels
  • Most commonly caused by hypercortisolism from ACTH-secreting pituitary tumor
  • Comments: If cause is pituitary tumor, then it’s called Cushing’s disease

Sample question:

A 52-year-old woman presents with amenorrhea and weight gain, especially in the centripetal area and in the dorsocervical fat pad. Physical exam reveals striae on the abdomen and a ruddy facial complexion. Blood pressure is 153/88 mm Hg. What is the most likely diagnosis?

By Yehuda Wolf, MPA, PA-C

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