Question

1.what are 3 signs of cushing syndrome that result from the breakdown of body proteins for energy?

2. what are the 3 characteristic signs of cushings that result from increased fat deposition and edema

Answer 1

1. Cushing’s syndrome is caused by the excessive production of cortisol by the adrenal gland. Cortisol, the stress hormone, is involved in maintaining blood pressure, reducing blood glucose levels, and inflammation and to digest lipids. Cushing’s syndrome can be caused by pituitary tumors that produce increased ACTH and adrenal tumors.

The deficiency of cortisol is known to result in breakdown of proteins that increases gluconeogenesis. Gluconeogenesis is formation of glucose from non-carbohydrate sources such as amino acids in liver. The classical symptom of purplish striae is caused by increased breakdown of proteins. This symptom is due to breakdown of collagen that results in fragile skin. This will make the venous supply in dermis visible, giving a purple hue to skin. Osteoporosis is caused by the increase in bone resorption in the body. Osteoporosis is due to the breakdown of type 1 collagen by osteoclast in response to higher cortisol levels. Poor wound healing is also due to breakdown of skin collagen, which results in defective response of heat shock protein to injury. As a result, there is poor wound healing observed in Cushing’s syndrome. Atrophy of type IIb muscle fiber proteins will result in muscle weakness.

2. Cushing’s syndrome causes increased fat deposition and edema. Fat deposition leads to obesity. Fat deposition is caused due to hyperinsulinemia and insulin resistance. This results in increased conversion of glucose into fat by the adipose tissue. Fat deposition will result in obesity and deposition of fat around base of neck (buffalo hump). Moon face (deposition of fats in cheeks and temporal fossae) and plethora (red, round face) is caused by fat deposition. Weight gain over the collar bone or supraclavicular fat pad is also observed in this disorder.

Swelling or edema is due to water retention in the skin. Mild bilateral edema is seen in these patients. Peripheral edema is seen as swelling in lower extremities (legs and feet) of the body.