Urgent management

• establish IV line with IV fluids

• hydrocortisone sodium succinate 200 mg IV

• arrange urgent hospital admission

Cushing's syndrome

The four main causes are:

• iatrogenic—chronic corticosteroid administration

• pituitary ACTH excess

• adrenal tumour

• ectopic ACTH or (rarely) corticotrophin-releasing hormone (CRH) from non-endocrine tumours, e.g. oat cell carcinoma of lung

The clinical features are caused by the effects of excess cortisol and/or adrenal androgens. Clinical features

• proximal muscle wasting and weakness

• central obesity, buffalo hump

• Cushing's facies: plethora, moon face, acne

• abdominal striae

• thin skin, easy bruising

• hypertension

• hyperglycaemia

• menstrual changes, e.g. amenorrhoea

• osteoporosis

• psychiatric changes, especially depression

Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

Get My Free Ebook

Post a comment