Endo: Cushing's Syndrome: Free MSRA Podcast

🎧 FREE MSRA PODCAST – Cushing’s Syndrome: Recognising Cortisol Excess EarlyIn this high-yield episode, we break down Cushing’s Syndrome, a vital endocrine topic often missed in early stages. Learn to confidently diagnose and manage it — whether due to exogenous steroids or endogenous tumours — and recognise when to suspect it in general practice.🧠 Key Learning Points📌 Definition• Clinical effects of excess cortisol• Exogenous (steroids – most common) or endogenous (pituitary, adrenal, ectopic sources)📌 Causes & Risk Factors• Exogenous steroids (e.g. prednisolone)• Endogenous: – Pituitary adenoma → Cushing’s disease – Ectopic ACTH (e.g. small cell lung cancer) – Adrenal adenoma/carcinoma• Pseudo-Cushing’s (alcoholism, depression)• Risk: steroids, female, age 25–40, MEN1, Carney complex📌 Pathophysiology• ↑ Cortisol → hyperglycaemia, fat redistribution, muscle wasting, hypertension, infections, osteoporosis📌 Clinical Features• Moon face, buffalo hump, purple striae• Proximal weakness, hypertension, diabetes• Hirsutism, menstrual issues, psychiatric symptoms• Children: growth delay• ACTH-dependent: skin pigmentation• Pituitary adenoma: headaches, visual issues📌 Differentials• Obesity, PCOS, metabolic syndrome, pseudo-Cushing’s, HIV, Nelson’s syndrome📌 DiagnosisInitial (2 of 3):24h urinary cortisol ↑Low-dose dex suppression – no suppressionMidnight cortisol ↑Next: ACTH level• ↓ ACTH → adrenal cause• ↑/normal ACTH → pituitary or ectopicFurther: High-dose dex test, IPSS, MRI/CT imaging📌 Management• Surgery: – Pituitary → transsphenoidal – Adrenal → adrenalectomy – Ectopic → resection – Bilateral adrenalectomy if unknown source• Medical: metyrapone, ketoconazole• Emergency: IV etomidate• Radiotherapy if surgery fails📌 Prognosis & Complications• Good with early surgery• Untreated → ↑ risk: CVD, osteoporosis, infections• After bilateral adrenalectomy → risk of Nelson’s syndrome• Ongoing risks: metabolic syndrome, VTE, vision loss📎 More MSRA Resources for Cushing’s Syndrome📝 Revision Notes:https://www.passthemsra.com/topic/cushings-syndrome-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/cushings-syndrome-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/cushings-syndrome-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/cushings-syndrome-rapid-quiz/🎓 Full Course:https://www.passthemsra.com/courses/endocrinology-for-the-msra/#MSRA #MSRARevision #MSRACushingsSyndrome #CushingsDisease #MSRAFlashcards #MSRAQuiz #Endocrinology #HyperCortisolism #PassTheMSRA #MSRAOnlineRevision