Cushing's syndrome physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with [[Cushing's syndrome]] usually appear obese. Physical examination of patients with Cushing's syndrome is remarkable for moon-like faces, [[easy bruising]], purple skin stria, and [[hirsutism]]. | Patients with [[Cushing's syndrome]] usually appear obese. Physical examination of patients with Cushing's syndrome is remarkable for moon-like faces, [[easy bruising]], purple skin stria, and [[hirsutism]]. | ||
==Physical Examination== | ==Physical Examination== | ||
===Appearance of the patient=== | ===Appearance of the patient=== | ||
*Patients with Cushing's syndrome usually appears overweight. | *Patients with Cushing's syndrome usually appears [[overweight]]. | ||
===Vital signs=== | ===Vital signs=== | ||
* [[Hypertension]], due to cortisol's enhancement of [[epinephrine]]'s vasoconstrictive effect. | * [[Hypertension]], due to [[Cortisol|cortisol's]] enhancement of [[epinephrine]]'s [[vasoconstrictive]] effect. | ||
===Head=== | ===Head=== | ||
* | *[[Moon face|Moon-face]] is a medical sign where the face swells up into a rounded shape. It is often associated with [[Cushing's syndrome]], which has led to it being known as Cushingoid facies ("Cushings-like face"), or [[steroid]] treatment, which has led to the name steroid facies. | ||
===Skin=== | ===Skin=== | ||
Revision as of 11:58, 24 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]
Overview
Patients with Cushing's syndrome usually appear obese. Physical examination of patients with Cushing's syndrome is remarkable for moon-like faces, easy bruising, purple skin stria, and hirsutism.
Physical Examination
Appearance of the patient
- Patients with Cushing's syndrome usually appears overweight.
Vital signs
- Hypertension, due to cortisol's enhancement of epinephrine's vasoconstrictive effect.
Head
- Moon-face is a medical sign where the face swells up into a rounded shape. It is often associated with Cushing's syndrome, which has led to it being known as Cushingoid facies ("Cushings-like face"), or steroid treatment, which has led to the name steroid facies.
Skin
- Hyperpigmentation - this is due to Melanocyte-Stimulating Hormone production as a byproduct of ACTH synthesis from Proopiomelanocortin (POMC)
- Telangiectasia (dilation of capillaries)
- Thinning of the skin (which causes easy bruising)
- Purple or red striae (the weight gain in Cushing's stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders)
- Hirsutism (facial male-pattern hair growth)
Eye
- Bitemporal hemianopsia - pituitary lesion may compress the optic chiasm
Neck
- Growth of fat pads along the collar bone and on the back of the neck (known as a lipodystrophy)
