Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 255.0 Cushing’s syndrome255.3 Other corticoadrenal overactivity255.6 Medulloadrenal hyperfunction ++ E24.0 Pituitary-dependent Cushing’s diseaseE24.2 Drug-induced Cushing’s syndromeE24.3 Ectopic ACTH syndromeE24.8 Other Cushing’s syndromeE24.9 Cushing’s syndrome, unspecifiedE27.5 Adrenomedullary hyperfunction ++ 4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with connective tissue dysfunction14E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation26B: Impaired aerobic capacity/endurance associated with deconditioning37B: Impaired integumentary integrity associated with superficial skin involvement4 ++ 315.4 Coordination disorder718.45 Contracture of joint, pelvic region and thigh719.70 Difficulty in walking involving joint site unspecified728.2 Muscular wasting and disuse atrophy, not elsewhere classified728.89 Disorders of muscle, ligament, and fascia729.9 Other and unspecified disorders of soft tissue780.7 Malaise and fatigue781.2 Abnormality of gait782.3 Edema786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath +++ Description ++ Excessive production and release of adrenal hormones, glucocortcoids (cortisol), androgens, and mineralocorticoids from the adrenal glandsAdrenal glands critical in regulating inflammation and cardiovascular functionInsidious or sudden onsetHigh cortisol levels +++ Essentials of Diagnosis ++ FatigueWeight gainDecreased activity toleranceHypertensionConfirmation of suspected disease through blood testing +++ General Considerations ++ Diagnosis for more occult problems may take time and require intensive diagnostic testingMay cause or be caused by pathology in multiple organ systemsCardiovascular: heart, peripheral circulation, blood pressureIntegumentaryMay result in secondary problems needing physical therapy intervention depending on severity such as: aerobic capacity/muscle endurance impairment, weakness/impaired muscle performance, musculoskeletal problems, neuromuscular problems, weight gain +++ Demographics ++ Males and females equally affectedCan develop at any age +++ Signs and Symptoms ++ FatigueWeight loss or gainLibido changesPallorFlushed faceChest painRapid breathingTachycardiaPalpitationsHypertensionExcessive thirstSweatingIncreased heat sensitivityHeadachesDecreased gastrointestinal motilityTinglingIncreased or decreased muscle bulkMuscle weaknessParalysisIncreased frequency of urinationIncreased bowel frequencyDarkening/hyperpigmentation of skinStretch marksAcneHyperglycemia or diabetesInability to absorb calciumWater retention, edemaThinning of skinEasy bruisingPoor wound healingAbdominal painDiarrheaVomitingNauseaDepression, irritability, personality changesTremorsLow-back pain in area of kidneysHypokalemiaIncreased sodium levelsHallucinationsAmenorrhea, menstrual irregularitiesReduced uterus or breast sizeInfertilityIncreased body or facial hairDeepened voiceBaldnessGrowth deficiency, short statureRound face, moon faceIncreased excess body fat in trunk and thoracic backOsteoporosisIncreased infection riskKidney stonesGoiterSleep disturbancesCushing’s syndromeAdrenal crisisComaShockSeizuresDeath +++ Functional Implications ++ Severe symptoms may be disabling, cause inability to leave homeFatigue, weakness, muscle-mass lossInability to ambulate or perform self-careLimited aerobic capacity or decreased exercise tolerance ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.