(Solved) Case Study on Susan
Added on 2021-04-17
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Running head: CASE STUDY ON SUSANCASE STUDY ON SUSANName of the student:Name of the university:Author note:
1CASE STUDY ON SUSANCushing syndrome takes place when individuals are exposed to prolonged periods ofelevated levels of either exogenous or endogenous glucocorticoids. It is mainly seen thatindividuals develop Cushing syndrome when they have abnormally high level of the cortisolhormones due to a variety of reasons. The healthcare professionals can identify a number ofsymptoms that help them in identifying the disorder of the individuals besides finding the levelof cortisol in the blood tests. Such symptoms usually include weight gain of the individuals,increased obesity, fat deposition mainly in the midsection of the face resulting in casing a roundand moon-shaped face (Nieman et al., 2015). The fat is also deposited in between the shouldersas well as in the upper back showing a humped structure like buffalo. Purple stretch marks alsooccur on the breasts, arms, abdomen as well as thighs of the individuals. Tinning of the skinresulting in bruises is also seen in such individuals. Moreover, acne, fatigue, skin injuries (whichheal slowly) all help professionals to identify the disorder. In the assignment, a patient namedSusan, had been admitted to the ward for treatment of her Cushing syndrome. The etiology andpathophysiology of the disorder would be discussed which would be then followed byidentifying the rationale of her degrading health condition after the laproscopic surgery. Theimportant members of the multidisciplinary teams members would be also discussed who wouldtake active participation in her treatment and care plan.Researchers are of the opinion that Cushing syndrome may occur due to medication aswell as by tumors. In many cases, tumors are present on the adrenal gland which results in themaking of a large amount of cortisol. In other cases, such symptoms may also occur whentumors are formed in the pituitary gland that is responsible for production of different hormonesin the body. Some of the pituitary gland tumors are responsible for production of huge amount ofadrenocorticoptrophic hormone called the ACTH. This hormone in turn cases the stimulation of
2CASE STUDY ON SUSANthe adrenal gland to produce more and more cortisol resulting in Cushing syndrome. In normalsituation, the hypothalamus in the brain is seen to have a pituitary gland situated just below it.The paraventricular nucleus (PVN) of the hypothalamus is responsible for releasing thecorticotrophin-releasing hormone called the CRH (Lonser, Nieman & Oldfield, 2017). This, inturn, is seen to stimulate the pituitary glands for the production of the ACTH. ACTH is seen totravel through blood thereby reaching to the adrenal gland were it results in the stimulation of thereleases of cortisol. This is mainly produced by the cortex of the adrenal gland from a region thatis called the zona fasciculata in response of the ACTH. When the level of the cortisol increasesin the blood, it results in the providing of the negative feedback on the CRH in thehypothalamus. This, in turn, is seen to decrease the amount of ACTH in blood from the pituitarygland that decreases the levels of cortisol in blood. However, in certain individuals, Cushingsyndrome is seen to take place when excess cortisol is released in the blood. One of the maincause for this disorder is the development of a cortisol secreting adenoma on the cortex ofadrenal gland (Lacrois et al., 2015). The adenoma is seen to increase the levels of cortisol in theblood that thereby imposes a negative impact on the ACTH levels and as aresult of it, the latter’slevel gets quite low. This is called the primary hypercortisolism or hypercorticism. Anothercause that may also result is the excess production of the ACTH from a corticotrophic pituitaryadenoma that thereby causes stimulation of the adrenal gland to produce more cortisols (Isodoriet al., 2015). This is called the secondary hypercorticolism. This may also take place due toexcess production of CRH from hypothalamus, this also initiates the pathways resultingexcessive cortsol, and this is called tertiary hypercortisolim. The tumors remain unresponsive ofthe negative feedback from cortisols and therefore, cortisol remains high in blood. In the patientprimary hypercorticolism has been found due to a presence of tumor on the adrenal gland.
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