2
AACN AGACNP Review Questions with verified detailed
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answers
Cushing's Syndrome/Disease - ✔✔cortisol excess typically caused by pituitary adenoma 60-
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70% of cases.
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Central obesity w/ extremity wasting.
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dorsocervical fat pad. || ||
rounded facies. ||
spontaneous bruising. ||
purple striae ||
hyperpigmentation
poor wound healing/ skin infections.
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Dexamethasone suppression test. || ||
1mg dexamethasone at 2300 hours and measure serum cortisol at 0800.
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Remove sources of excess and manage consequences ( HTN, hypokalemia, hyperglycemia.)
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Addison's disease - ✔✔Primary || || ||
Caused by damage to the adrenal cortex (autoimmune, TB, metastatic disease, deposition
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diseases, and drug induced) leading to a decrease in cortisol production.
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Secondary
Caused by pituitary failure to release ACTH (in any hypopituitary disorder) causing a
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decrease in cortisol production.
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, 2
Sudden withdrawal of systemic corticosteroids leading to a decrease in cortisol production
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from induced corticosteroid suppression.
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diabetes insipidus (DI) - ✔✔Insufficient ADH or decreased sensitivity to ADH
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Nephron cannot conserve water. || || ||
Commonly caused by damage to the pituitary gland or hypothalamus (surgery, tumor,
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meningitis, head injury). || ||
Can be nephrogenic where the kidney in unable to respond to ADH.
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Serum: Hypernatremia and hyperosmolarity.
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Urine: Hyponatremia and hypoosmolality.
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Replaced ADH and supportive fluid replacement.
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Syndrome of Inapropriate Antidiuretic Hormone (SIADH) - ✔✔Excess ADH production.
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Nephron conserves excess water. || || || ||
Caused by head injury and lung cancers.
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Serum: Hyponatremia and hypoosmolality.
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Urine: Hypernatremia and hyperosmolarity.
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AACN AGACNP Review Questions with verified detailed
|| || || || || || ||
answers
Cushing's Syndrome/Disease - ✔✔cortisol excess typically caused by pituitary adenoma 60-
|| || || || || || || || || ||
70% of cases.
|| || ||
Central obesity w/ extremity wasting.
|| || || ||
dorsocervical fat pad. || ||
rounded facies. ||
spontaneous bruising. ||
purple striae ||
hyperpigmentation
poor wound healing/ skin infections.
|| || || ||
Dexamethasone suppression test. || ||
1mg dexamethasone at 2300 hours and measure serum cortisol at 0800.
|| || || || || || || || || || ||
Remove sources of excess and manage consequences ( HTN, hypokalemia, hyperglycemia.)
|| || || || || || || || || ||
Addison's disease - ✔✔Primary || || ||
Caused by damage to the adrenal cortex (autoimmune, TB, metastatic disease, deposition
|| || || || || || || || || || || ||
diseases, and drug induced) leading to a decrease in cortisol production.
|| || || || || || || || || ||
Secondary
Caused by pituitary failure to release ACTH (in any hypopituitary disorder) causing a
|| || || || || || || || || || || || ||
decrease in cortisol production.
|| || || ||
, 2
Sudden withdrawal of systemic corticosteroids leading to a decrease in cortisol production
|| || || || || || || || || || || ||
from induced corticosteroid suppression.
|| || ||
diabetes insipidus (DI) - ✔✔Insufficient ADH or decreased sensitivity to ADH
|| || || || || || || || || ||
Nephron cannot conserve water. || || ||
Commonly caused by damage to the pituitary gland or hypothalamus (surgery, tumor,
|| || || || || || || || || || || ||
meningitis, head injury). || ||
Can be nephrogenic where the kidney in unable to respond to ADH.
|| || || || || || || || || || || ||
Serum: Hypernatremia and hyperosmolarity.
|| || ||
Urine: Hyponatremia and hypoosmolality.
|| || || ||
Replaced ADH and supportive fluid replacement.
|| || || || ||
Syndrome of Inapropriate Antidiuretic Hormone (SIADH) - ✔✔Excess ADH production.
|| || || || || || || || ||
Nephron conserves excess water. || || || ||
Caused by head injury and lung cancers.
|| || || || || ||
Serum: Hyponatremia and hypoosmolality.
|| || ||
Urine: Hypernatremia and hyperosmolarity.
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