All about Cushing's! - malvika

[ArchivalUser]

Can anyone explain the following "Cushing" terms?

Cushing's syndrome
Cushing's disease
Cushing's Triad
Cushing's reflex?

[ArchivalUser]

Cushing's syndrome- Hypercortisolism ie glococorticoid excess from any cause including cushing's disease.
Cushing's disease- pituitary cause glucocoticoid excess.
Cushing's Triad- due to raised ICT-
1. Hypertension.
2. Bradycardia.
3. abnormal respirations

Cushing's reflex- increased BP, decreased heart rate.
A hypothalmic response to ischaemia, usually due to poor perfusion to the brain.
Ischaemia ----> activates sympathetic nervous system--->increase in the heart's output + peripheral constriction of the blood vessels---->causes rise in blood pressure, ensuring blood delivery to the brain.
The increased blood pressure---->stimulates the baroreceptors-----> activation of the parasympathetic nervous system, which slows down the heart rate, causing the bradycardia

[ArchivalUser]

Excellant,Destiny's choice! Very detailed and informative--thank you soo much!

[ArchivalUser]

hope it helps
It was a favourite question in my MRCS exams - cushing reflex and
i have personally seen such a case pt came with head injury GCS 4-5/ 15, pupils fixed, checked his BP it was 170 / 100 mmof Hg. was expecting tachycardia but the heart rate was 40 - 50 b/ sec , that was when my consultant told me about cushing reflex... any way the pt died

my consultant also told that once U see the cushing triad that means the pt will cone any time... and that happened.

ideally they do a decompression crainotomy...

so i can never forget cushing reflex...

[ArchivalUser]

and dont forget about cushings ulcer, a stress ulcer!

[ArchivalUser]

Thats so interesting, destiny--really experience is the best teacher! Hey, thanks docspring ,for another forgotten Cushing's association!

[ArchivalUser]

You are welcome.