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CUSHING DISEASE: hypercortisolism secondary to ACTH-producing pitiutary adenoma. CUSHING SYNDROME: hypercortisolism from any cause (e.g. pituitary adenoma, adrenal adenoma, ectopic ACTH, exogenous glucocorticoids) Comment: Typical presentation is hypertension, central obesity, muscle weakness, psychiatric symptoms, hirsutism. Diagnosis is via 24H urine free cortisol or two 11pm salivary cortisol levels. If elevated, give 1 mg of dexamethasone at bedtime and measure AM cortisol. Johns Hopkins Internal Medicine Board Review: Certification and Recertification (4th Edition)    (retrieved Apr, 2014). There are currently 1090 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2024 by the Internet Medical Association. Click Here to view more medical pearls.