NUR241 Case Study: Cushing Syndrome Diagnosis and Treatment Plan

This assignment presents a case study of Sara Haines, a 38-year-old patient presenting with symptoms indicative of Cushing Syndrome, including drastic weight gain, facial hair growth, menstrual abnormalities, and excessive thirst and appetite. The analysis explores the potential causes of Cushing Syndrome, differentiating between endogenous factors like tumors and exogenous factors such as medications. In Sara's case, the long-term use of betamethasone for asthma treatment is identified as a likely contributor. The assignment also details common signs and symptoms of the disorder, such as obesity, skin changes, slow wound healing, and mental health issues, correlating them with Sara's reported conditions. References to relevant research articles support the discussion, providing a comprehensive overview of Cushing Syndrome diagnosis and management. Desklib offers a wealth of study resources, including solved assignments and past papers, to aid students in their academic pursuits.

Running head: CUSHING SYNDROME
CUSHING SYNDROME
Name of the student:
Name of the university:
Author note:

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Answer 1:
Cushing syndrome mainly occurs due to tumors and due to medication. Tumor is mainly
the endogenous cause of Cushing syndrome and is the less common cause of the disorder. The
tumors may be both cancerous as well as non-cancerous. Medication is mainly seen to be the
most common exogenous cause of the occurrence of Cushing syndrome as it originates outside
the body. Researchers are of the opinion that cortisol-like steroid drugs as well as glucose-
corticoids are some of the medications that had been intricately linked with the occurrence of the
Cushing syndrome (Isidori, 2015). Medications of certain disorders that act as the risk factor of
the Cushing syndrome are allergies, asthma as well as autoimmune system that attack its own
tissues or organ transplantation. In case of the patient, it is seen that she takes a medication called
betamethosone that is used for the treatment of asthma for many years (Dalmazi & Reincke,
2018). Therefore, this medication might have been the main cause of the occurrence of Cushing
syndrome. In the normal cases, hypothalamus helps in production of corticotrophin that
stimulates the pituitary gland to release the ACTH hormone or the adrenocorticotrophic hormone
(Lonser, Nieman, & Oldfield, 2017). Then ACTH stimulates the adrenal glands to produce
cortisol. When the levels of cortisol increase in blood due to occurrence of tumor or due the use
of medications mainly steroids, it results in development of the disorder. In case of the patient,
her medication taken for asthma is the main cause of occurrence of Cushing syndrome.
Answer 2:
Some of the most common sign and symptoms involve progressive obesity as well as
skin changes. Researchers are of the opinion that weight gain and fatty tissue mainly around the
midsection and upper back and in the face and between the shoulders. Pink and purple stretch

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marks also develop along with the thinning of the skins (Lacroix et al., 2015). The patient in the
case study had also gained weights and developed similar symptoms. Slow healing of the
wounds, cuts as well as insect bites and infections. Women with the Cushing syndrome
experience thicker or more visible body as well as facial hair. Men with the Cushing syndrome
are seen to have decreased libido, decreased fertility as well as erectile dysfunction. Some of the
symptoms that also accompany the disorder are severe fatigue as well as muscle weakness
(Yorke et al., 2017). Depression, anxiety as well as irritability and loss of emotional control can
also accompany the disorders. Other symptoms which are quite common in the disorder are
cognitive difficulties, new or worsened high blood pressure and headache (Nieman, 2015). Bone-
loss that leads to fractures over time are also the symptoms that remain closely associated. High
blood pressure, a headache, cognitive dysfunction are also some other symptoms. Anxiety,
irritability, depression as well as increased incidence of infections also take place with the
disorders (Bauduin, van der Wee & van der Werff, 2018). Edema, diabetes as well as ruddy
complexion are also seen to occur in the disorder. Many less common symptoms associated with
the disorder are insomnia, recurrent infection, easy bruising, thin skin and stretch marks, acne
and depression (Nieman, 2018). Other less common features are weak bones, balding, hip and
shoulder weakness, swelling of feet as well as legs and even diabetes.

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References:
Bauduin, S. E., van der Wee, N. J., & van der Werff, S. J. (2018). Structural brain abnormalities
in Cushing's syndrome. Current Opinion in Endocrinology, Diabetes and Obesity, 25(4),
285-289.
Di Dalmazi, G., & Reincke, M. (2018). Adrenal Surgery for Cushing Syndrome: An
Update. Endocrinology and metabolism clinics of North America.
Isidori, A. M., Graziadio, C., Paragliola, R. M., Cozzolino, A., Ambrogio, A. G., Colao, A., ... &
Pivonello, R. (2015). The hypertension of Cushing's syndrome: controversies in the
pathophysiology and focus on cardiovascular complications. Journal of
hypertension, 33(1), 44.
Lacroix, A., Feelders, R. A., Stratakis, C. A., & Nieman, L. K. (2015). Cushing's syndrome. The
lancet, 386(9996), 913-927.
Lonser, R. R., Nieman, L., & Oldfield, E. H. (2017). Cushing's disease: pathobiology, diagnosis,
and management. Journal of neurosurgery, 126(2), 404-417.
Nieman, L. K. (2015). Cushing's syndrome: update on signs, symptoms and biochemical
screening. European journal of endocrinology, 173(4), M33-M38.

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Nieman, L. K. (2018). Diagnosis of Cushing’s Syndrome in the Modern Era. Endocrinology and
metabolism clinics of North America, 47(2), 259-273.
Yorke, E., Atiase, Y., Akpalu, J., & Sarfo-Kantanka, O. (2017). Screening for Cushing syndrome
at the primary care level: what every general practitioner must know. International
journal of endocrinology, 2017.