Case Study 52 Cushing Syndrome

1) Of the vitals signs listed above, which of them has to be of most concern to the patient’s PCP?

This patients BP is very high.

2) Assuming that the patient has hypercortisolism, briefly explain the pathophysiology of the
abnormal vital sign noted in Question1.

The hypercortisolism can leas to prolonged high BP.

3) IS this patient technically underweight, overweight, obese, or is her weight conserved healthy
and normal?

This patient is considered overweight.

4) Assuming that M.K. has hypercortisolism, what are the two possible causes of their patient’s
persistent, dull head pain?

m
er as
The increased BP and the pituitary gland not working due to tumor.

co
eH w
5) What is the significance in the patient’s report that she is not talking any medications other than
a daily multivitamin and ibuprofen?

o.
rs e
A common cause of Cushing Syndrome is due to the use of steroids. The patient is not taking any of
ou urc
these medications so it must be another reason.

6) Identify the nine abnormal laboratory test results in Table 52.1.

o

The patient’s potassium and lymphocytes are low. She also has elevated fasting glucose, ACTH, serum
aC s

cortisol, urinary free cortisol, pH, serum testosterone and neutrophils.

vi y re

7) Why is serum glucose elevated?

The excessive cortisol levels.

ed d

8) Explain the pathophysiology that underlies polydipsia in this patient.

ar stu

Her glucose intolerance can make this patient feel excessive thirst.

9) Do laboratory test results suggest that hypercortisolism in M.K. is ACTH-dependent or ACTH

is

independent?
Th

The results show a ACTH-dependent.

10) What is the significance of the serum K+ concentration and the pH of the arterial blood?
sh

The K+ is moving into cells from the plasma while cells are giving up hydrogen ions.

11) Note that hyperpigmentation of the skin and gingiva was a physical finding in their patient. Is this
clinical manifestation more characteristic of ACTH dependent or ACTH independent Cushing
Syndrome?

This is characteristic of ACTH-dependent Cushing syndrome

This study source was downloaded by 100000829356667 from CourseHero.com on 07-19-2021 07:48:39 GMT -05:00

https://www.coursehero.com/file/73600439/Case-Study-52-Cushing-Syndromdocx/
 12) Which imaging techniques might be critical to establishing a specific cause of hypercortisolism in
their patient?

A CT scan is pertinent to identify the tumor.

13) What type of menstrual abnormality would be suspected in this patient and which abnormal
laboratory test result is consistent with their type of abnormality?

The levels of testosterone are so high the blood flow would be slowed or unusual hair growth.

14) What is the treatment of choice for curing hypercortisolism in this patient?

I would think it would be removal of the tumor in the pituitary gland.

15) Patient Case Figure 52.1 shows that an enlarged Sella turcica is a potential clinical manifestation
of Cushing syndrome/disease. Explain the association.

The pituitary glad sits in the Sella turcica. The enlargement is probably due to a hyperfunctioning

m
pituitary gland.

er as
co
16) Why is cardia hypertrophy shown as a clinical manifestation of Cushing Syndrome in Patient Case

eH w
Figure 52.1?

o.
The excessive release of glucocorticoids can cause atrophy of the heart.
rs e
ou urc
o
aC s
vi y re
ed d
ar stu
is
Th
sh

This study source was downloaded by 100000829356667 from CourseHero.com on 07-19-2021 07:48:39 GMT -05:00

https://www.coursehero.com/file/73600439/Case-Study-52-Cushing-Syndromdocx/
Powered by TCPDF (www.tcpdf.org)