Syndromes

Question 1

What is Cushing’s syndrome?

Answer 1

Cushing’s syndrome (hypercortisolism) is a collection of symptoms caused by very high levels of a hormone called cortisol in the body.

The symptoms of Cushing’s syndrome include:

• weight gain
• thinning skin that bruises easily
• reddish-purple stretch marks on the thighs, stomach, buttocks, arms, legs or breasts
• fat deposits that develop in the face, causing it to become round
• muscle or bone weakness
• decreased interest in sex (loss of libido)

Question 2

Which drugs may cause Cushing’s syndrome?

Answer 2

Corticosteroids

Question 3

What is Reye’s syndrome and symptoms defining it?

Answer 3

Rare disorder which can cause serious/fatal liver and brain damage.

Symptoms include:

Repeated vomiting
Fatigue/ lack of interest
Rapid breathing
Seizures

Progressive symptoms include;

Irritability or aggressive behaviour
Severe anxiety
Coma

Question 4

What is Stevens-Johnson Syndrome and characteristics of it?

Answer 4

Rare diorder which affects the skin, mucous membrane, genitalia and eyes

Symptoms include;

High temperature
Headache
Joint pain
Cough

Rash - appears like a target (darker in the middle and lighter around the edge)
- rash is NOT itchy and spreads over hours or days.
Large blisters then develop from it which after bursting leaves painful sores

Facial swelling and swollen lips covered in crusty sores also a characteristic feature

Mucous membranes inside your mouth, thirst, eyes and genital tract may also become blistered and ulcerated

Question 5

Which medications are associated with a high risk of SJS?

Answer 5

Allopurinol 
Carbamazepine 
Sulfonamides 
Lamotrigine 
Phenobarbital 
Phenytoin 
Sertraline

Question 6

What is serotonin syndrome and clinical features of it?

Answer 6

Excess of serotonin usually as a result of adverse drug reaction from drugs such as SSRIs or MAOIs

Clinical features can be classified broadly into three groups:

1) altered mental state
- anxiety
- agitation
- confusion
- coma

2) neuromuscular dysfunction
- tremor
- Clonus
- occular clonus
- hypertonicity
- hyperreflexia

3) autonomic disturbance
- hypertension
- tachycardia
- hyperthermia
- Mydriasis (dilation of the pupil)
- excessive sweating

Question 7

What is Kawasaki disease and the clinical features of it?

Answer 7

Rare condition which mainly affects children under the age of 5

Symptoms include:

• rash
• swollen glands in the neck
• dry, cracked lips
• red fingers/ toes
• red eyes

Question 8

What is Addison’s disease?

Answer 8

Addison’s disease (also known as primary adrenal insufficiency or hypoadrenalism) is a rare disorder of the adrenal glands.

Symptoms:

• General weakness and becoming easily tired.
• Darkened areas of skin (pigmentation). The cause of this is probably due to the change in hormones which can affect the pigment cells in the skin. Pigment changes mainly occur on:
• Sun-exposed areas of skin.
• Armpits.
• Nipples.
• The creases of the hands.
• Gums and inside the mouth.
• Recent (rather than old) scars.
• Pressure points such as the elbows.
• Blood pressure which is low and falls further when you stand, which can make you dizzy.
• Being off your food.
• Loss of weight.
• Feeling sick and being sick (vomiting) from time to time.
• Tummy (abdominal) pains which may come and go.
• Diarrhoea or constipation which may come and go.
• Cramps and pains in muscles.
• Craving for salt or for salty foods and drinks.
• Menstrual periods in women may become irregular or stop.

Question 9

What is neuroleptic malignant syndrome?

Answer 9

Rare and potentially life-threatening side effect associated with antipsychotic use.

Characterised by:

• hyperthermia
• fluctuating levels of consciousness
• muscle rigidity
• autonomic dysfunction
• tachycardia
• labile blood pressure
• sweating
• urinary incontinence