Cushing syndrome, Addison disease, pituitary adenomas, and ADH disorders (SIADH and diabetes insipidus) with their hallmark lab findings.
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- What is Cushing syndrome caused by?
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Chronic exposure to excess cortisol- What is the most common overall cause of Cushing syndrome?
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Exogenous glucocorticoid use (e.g., prednisone therapy)- What is the most common cause of endogenous Cushing syndrome?
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An ACTH-secreting pituitary adenoma (Cushing disease)- What is the classic tumor causing ectopic ACTH secretion?
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Small cell lung carcinoma- What is the purpose of the low-dose dexamethasone suppression test?
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To screen for Cushing syndrome (normally cortisol suppresses, but fails to in Cushing)- In Cushing disease (pituitary source), does cortisol suppress with high-dose dexamethasone?
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Yes, it suppresses- In ectopic ACTH-secreting tumors, does cortisol suppress with high-dose dexamethasone?
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No, it fails to suppress- What skin finding is classic for Cushing syndrome?
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Purple (violaceous) abdominal striae- What electrolyte abnormality is seen in Cushing syndrome, especially with ectopic ACTH?
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Hypokalemic metabolic alkalosis- Why does Cushing syndrome cause hyperglycemia?
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Cortisol stimulates gluconeogenesis and antagonizes insulin- What is a first-line screening test for Cushing syndrome?
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24-hour urinary free cortisol- What bone complication results from chronic Cushing syndrome?
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Osteoporosis (cortisol inhibits osteoblast activity)- What is Addison disease?
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Primary adrenal insufficiency (the adrenal cortex itself fails)- What is the most common cause of primary adrenal insufficiency in developed countries?
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Autoimmune adrenalitis- What electrolyte finding is seen in Addison disease due to aldosterone deficiency?
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Hyperkalemia
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