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Easily excitable

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Psychiatric symptoms in patients with Cushing's syndrome, such as prone to excitement, depression, and even schizophrenia. Cushing's syndrome is a syndrome caused by excessive secretion of cortisol from the adrenal cortex, also known as hypercortisolism. Among them, Cushing's syndrome caused by excessive secretion of adrenocorticotropic hormone (ACTH) in the pituitary gland is called Cushing's disease. Often started to be annoyed, head swelling and pain, faint and sultry, head ribs protruding, mouth dry mouth bitter, even the ears are deaf, the tongue is thin yellow, pulse like string or number.

Cause

Cause

1. ACTH-dependent Cushing's syndrome, including Cushing's disease and ectopic ACTH secretion syndrome. The former accounted for about 70% of Cushing's syndrome, 80% of patients have microadenomas in the pituitary, secreting excessive ACTH and causing bilateral adrenal hyperplasia. The most common cause of ectopic ACTH syndrome is bronchial lung cancer, especially oat cell carcinoma, followed by thymoma, islet cell tumor, carcinoid and other extracorporeal tumors. In addition, some ectopic tumors can secrete ACTH-releasing hormone, which can also cause ACTH-dependent Cushing's syndrome.

2, non-ACTH-dependent Cushing's syndrome, mainly caused by adrenal adenoma and adenocarcinoma, is the second cause of Cushing's syndrome. In addition, long-term, large-scale use of glucocorticoids and alcohol abuse can also cause non-ACTH-dependent Cushing's syndrome.

Examine

an examination

Related inspection

X-ray lipiodol angiography CT examination of cerebrospinal fluid cyclophosphate guanosine

1, obesity, purple lines, due to excessive cortisol caused by abnormal fat distribution and excessive protein decomposition, patients have more centripetal obesity, face like a full moon, limbs thin and thin. The skin is thin and easy to cause freckles, and the purple skin is formed due to the breakage of the skin elastic fibers. Osteoporosis and pathological fractures are common.

2, blood pressure and metabolic abnormalities, patients often have high blood pressure, hypokalemia, alkalosis and glucose metabolism disorders, the incidence of diabetes and impaired glucose tolerance in Cushing's syndrome each accounted for about 20%.

3, abnormal gonad function, growth and development of childhood disease can be affected, adult patients with decreased sexual desire. Female patients often have menstrual disorders and amenorrhea, and some of them are hairy and masculine due to the secretion of a large number of adrenocortical androgen in adrenal cortical carcinoma; male patients may develop impotence.

4, mental symptoms, common people include easy to be excited, depressed, etc., and even have the performance of schizophrenia.

Diagnosis

Differential diagnosis

Easy to differentiate differential diagnosis:

Emotional Outbreak: This is a sudden emotional disorder that suddenly occurs under the influence of psychological factors. The patient can show moodiness, yelling, wrecking, smashing, screaming, crying, or screaming, dancing, laughing, often accompanied by spoiled, artificial, childish and acting colors, sometimes rolling on the ground, extremely violent, the whole The phenomenon is very different, and the change is great, but the perception of the surrounding things is unobstructed and the consciousness is clear.

Rage is a kind of emotional reaction when you are dissatisfied, and often makes some venting behaviors, while serious people lose their senses. Anger can cause hallucinations in the ear, such as auditory hallucinations, visual hallucinations, and medical endocrine disorders. There may also be diseases such as schizophrenia, and special care should be taken for machinery and transportation.

Impulsive behavior refers to an act that suddenly occurs and usually causes adverse consequences; a violent behavior refers to an act that intentionally causes damage to property or other person's body and mind. The attacking object may be itself, another person, or an object. Attacks on others include physical and sexual attacks that can cause injury, disability, and death. Attacks on objects can cause economic losses. In addition to the specific behaviors that appear, impulsive and violent tendencies can be expressed as potential behaviors, such as threatening speech or gestures. WHO (2002) has a broader definition of violence: Threats to use or have deliberately used force or power against themselves, others, a specific group of people or a particular society, causing or highly likely to cause injury, death, Psychological injury, deformity or living conditions are deprived."