Cushing Syndrome Mnemonic for USMLE

As osteoblast activity is inhibited, patients with prolonged Cushing syndrome can develop osteoporosis.

Excess cortisol influences other hormones, and in women leads to increased androgens. This presents as amenorrhea or oligomenorrhea in female patients.

Patients develop rapid weight gain, which manifests as central or truncal obesity.

In Cushing syndrome, skin tends to become thin, fragile, and more susceptible to infections and bruising. Abdominal striae also develop, due to skin stretching and hemorrhage.

A common distribution of weight gain in patients with Cushing syndrome is in the upper back and base of the neck. This pattern of weight gain is called a "buffalo hump."

As increased cortisol suppresses the immune system, people with Cushing syndrome are more prone to developing infections.

Development of Cushing syndrome may cause patients to have fat collection in the face. This distribution pattern is called a "moon face."

Patients also display persistent hypertension, as cortisol enhances epinephrine's vasoconstrictive effects.

Cortisol excess can cause insulin resistance, when can eventually develop into type II diabete mellitus.

Diagnosis of Cushing syndrome can be made with a 24-hour urine free Cortisol test. This helps discover high levels of Cortisol in patient circulation.

The dexamethasone suppression test is very helpful in diagnosing Cushing syndrome. This is because through administration of dexamethasone and frequent determination of cortisol and ACTH level, the etiology of excess cortisol secretion can be found.