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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Saturday, January 14, 2023

Cushing’s Syndrome

emDOCs EM@3AM - By Rahul Ramraj; Pinaki Mukherji
Reviewed by: Sophia Görgens; Cassandra Mackey; Brit Long
Pearls
  • Consider CS when one sensitive and one specific sign (i.e.: obesity + striae; hirsutism + new psychosis)
  • Begin empiric treatment if severe CS suspected: metyrapone, ketoconazole, or etomidate
  • Confirm suspicion with random serum cortisol > 36 µg/dL (1000 nmol/L)
  • Treat associated disorders – cardiovascular disease (cardiac failure, hypertension), venous thrombosis, infections (sepsis, peritonitis), metabolic complications (diabetes, hypokalemia)
  • Bilateral adrenalectomy – when refractory to medical interventions in severe CS