Caring for Exogenous Cushing Syndrome’s Patient

Caring for Exogenous Cushing Syndrome’s Patient
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Case study chosen; 2
Question one; Exogenous Cushing Syndrome
The major disease that Maureen is infected with is the Exogenous Cushing Syndrome.
The disease is a disorder in which the Cushing syndrome occurs due to the higher level of
cortisol hormone than normal.
Cause
Exogenous Cushing syndrome occurs to a person when he/she uses synthetic
glucocorticoid medicines to treat a disease. Exogenous means something from outside the body,
such that the exogenous Cushing syndrome will occur when a person uses human-made
glucocorticoid medicines to treat an illness. Some of the diseases that are mostly treated with
glucocorticoids medicines are inflammatory bowel disease, joints disease like rheumatoid
arthritis, type 2 diabetes and brain tumors (Sharma, Nieman &Feelders, 2015).
Incidence
According to the case study two, the patient, Maureen was diagnosed with two diseases;
rheumatoid arthritis (RA) and type two diabetes. Maureen was diagnosed with RA at an early
age when she was 15 years. After multiple exacerbations of rheumatoid arthritis, she was advised
by her general practitioner (GP) to start using a high dose of corticosteroids. For type two
diabetes, Maureen uses metformin for control. The two diseases that Maureen has been
diagnosed with are the major incidences that have led to the occurrence of the exogenous
Cushing syndrome due to the synthetic medicines she has been using to treat those diseases.
Risk factors

A person with exogenous Cushing syndrome may develop some of the health
complications which are as follows; a person with a low immune system may have frequent
cases of infections. An exogenous Cushing syndrome patient is at risk of developing diabetes
complication as Maureen has developed type 2 diabetes. Risk of blood clots is high to a person
with exogenous Cushing syndrome. A person with this disease develops complications like
osteoporosis (weak bones) and increased risk of fractures.
Impact on the patient and the family
The clinical complications of the exogenous Cushing's syndrome negatively do impact
the quality of life of the patient due to the increased morbidity due to other infective diseases and
cardiovascular complications. The patient with Cushing’s syndrome is advised to visit a
neurocognitive specialist and psychiatrist due to patient’s mental disorders like mania,
depression and anxiety. This is because most patient suffering from Cushing syndrome
frequently do complain of changes in the physical appearance like where Maureen’s face started
to become round, her fats mainly concentrated at her abdominal area and a hump between her
shoulders. Other complain that Maureen’s husband noticed were fatigue and emotional
instability as it interferes with the family life and workplace performance.
The disease has a lot of impact on the family in terms of daily activities and medical cost.
Also, there are a lot of duties that are affected in the family that could be done by the patient.
After the patient is discharged from the hospital due some of the required exacerbations like in
Maureen’s case, her husband has a burden of duties and daily activities to perform while taking
care of her to ensure a quick recovery. The family member as in Maureen’s husbands also suffers
depression due to the observable changes that occur to her wife both physical and emotional
(Wagner-Bartaket al, 2017).

Question two; Signs and Symptoms
Signs and Symptoms Pathophysiology
Abdominal pain. Maureen had a body mass
index of 28kg/m2,and fat accumulation was
mainly contributed around her abdominal area
and a high level of low lipoprotein cholesterol
density. The patient had increased weight gain
due to the accumulation of fat around the
abdomen, but fat lacked in the arms, legs, and
buttocks which are commonly known as
central obesity (Dumesicet al, 2015).
This is induced by the visceral nociceptors
stimulation. Pathological events such as for
ischemia and inflammation are required for
the activation of the nociceptors. It is
evidenced that pain states are associated with
profound alterations of the sensory input. The
Abdominal pain can occur due to the
pathology of the visceral structure which only
explains the pain complains as there are no
objective signs of the visceral lesions
(Dumesicet al, 2015).
Gastrointestinal (GI) bleeding. There is
perforation of the gastrointestinal when a
patient has exogenous Cushing syndrome.
Maureen may have developed gastrointestinal
bleeding as a result of multiple exacerbations
of rheumatoid arthritis which led her to use a
high dosage of corticosteroids. Some of the
signs of GI bleeding include; tarry stool,
dizziness, paleness, abdominal cramps,
tiredness and stool mixed with bright red
The pathophysiology of gastrointestinal
bleeding is as a result of elevated portal
pressure conveyed to the gastric varices and
the esophageal leading to gastropathy. The
common cause of gastrointestinal bleeding is
peptic ulcers which are open sores that
develop on the lining of the duodenum. As a
symptom of Cushing disease gastrointestinal
bleeding is associated with hypercortisolism
the patient because of elevated levels of