cushing syndrome essay
This case involves a 12-year old female child who presents with her mother. The clinician notes that the child has a moon face appearance, a buffalo hump fat pad on the upper back and has only grown ½ inch within 2 years now 5 feet tall. The child is reportedly depressed and tired unlike before.
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Tests I Would Like To Order for This Patient
I would order for a 24-hour urinary free cortisol test, late-night and midnight salivary cortisol tests. These tests would be helpful in establishing the levels of cortisol in urine and saliva to confirm the diagnosis before the initiation of treatment. A low-dose dexamethasone suppression test will help to assess the functioning of the adrenal gland. In this test, a measure on how the levels of cortisol change when responding to injection with dexamethasone is ascertained (Bronstein, 2015). A CT Scan or MRI of the brain is also significant in establishing any abnormalities in the adrenal or pituitary glands cushing syndrome essay.
Working Diagnosis and Treatment Plan for This Patient
In this case, my working diagnosis is Cushing syndrome. The latter is a condition that results from too much cortisol in the body and results to several symptoms such as; easily bruised skin, mood swings, chronic tiredness, depression, impaired growth in children, a moon face and a back hump due to the accumulation of fat (In Laws & In Pace, 2016). The treatment plan is highly dependent on the cause. Incase the patient is taking a corticosteroid medication, the drug will slowly be tapered off. If the cause is found to be an adrenal adenoma, a surgery will be scheduled for its removal and the child will receive steroid replacement therapy afterwards (In Laws & In Pace, 2016). Incase it’s a tumor, radiotherapy, surgery and rescriptions of drugs to reduce cortisol effects in the body is the most definitive treatment approach cushing syndrome essay.
References
Bronstein, M. D. (2015). Cushing’s Syndrome : Pathophysiology,
Diagnosis and Treatment. Estados Unidos: Humana Press.
In Laws, E. R., & In Pace, L. (2016). Cushing’s disease: An often misdiagnosed and not so rare
disorder cushing syndrome essay.