Endocrine System: Addison's Disease and Cushing Syndrome

Cushing Syndrome

• Definition: Cushing syndrome occurs when the adrenal glands produce an excess of steroid hormones, specifically cortisol.
• Causes:
  • Overproduction of cortisol due to adrenal gland hyperactivity
  • Long-term use of exogenous steroids
  • Tumor on the pituitary gland causing excess ACTH (Cushing's Disease)
• Symptoms:
  • High blood pressure
  • High sodium
  • High blood sugar
  • High risk of infections
  • Excessive body hair
  • Big round abdomen, overweight
  • Moon face
  • Buffalo hump
  • Stretch marks
  • Rosy cheeks
• NCLEX Tip: Remember Moon Face and Buffalo Hump as key signs.
• Treatment:
  • Reduce steroid dosage if exogenous cause
  • Surgical removal of affected gland or tumor:
    • Adrenal gland in Cushing syndrome
    • Pituitary tumor in Cushing's Disease
  • Hormone replacement therapy required if gland or tumor is removed
  • Risk of Addisonian Crisis if untreated

Addisonian Crisis

• Definition: Life-threatening condition due to insufficient cortisol levels.
• Triggers:
  • Failure to compensate during stress (surgery, illness, injury, infection)
• Treatment:
  • IV push of steroids
  • Fluids or dextrose for low blood pressure or hypoglycemia
  • Monitor for fluid retention, weight gain, hyperglycemia, cataracts, slow wound healing

Addison's Disease

• Main Treatment: Lifelong steroid therapy
• Risks if untreated:
  • Increased risk of Addisonian Crisis

General Tips

• Hormone Replacement: Essential if glands are removed to prevent Addisonian Crisis
• Stress Management: Critical to avoid Addisonian Crisis

Additional Resources

• Study sheets available for further review