1
AACN AGACNP Review | Verified Questions and
100% Correct Answers Graded A+
Cushing's Syndrome/Disease
- Correct Answer-
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.
1
, 2
Remove sources of excess and manage consequences (
HTN, hypokalemia, hyperglycemia.)
Addison's disease
- Correct Answer-
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.
Sudden withdrawal of systemic corticosteroids leading to a
decrease in cortisol production from induced corticosteroid
suppression.
diabetes insipidus (DI) - Correct Answer-Insufficient ADH
or decreased sensitivity to ADH
Nephron cannot conserve water.
2
, 3
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)
- Correct Answer-Excess ADH production.
Nephron conserves excess water.
Caused by head injury and lung cancers.
Serum: Hyponatremia and hypoosmolality.
3
AACN AGACNP Review | Verified Questions and
100% Correct Answers Graded A+
Cushing's Syndrome/Disease
- Correct Answer-
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.
1
, 2
Remove sources of excess and manage consequences (
HTN, hypokalemia, hyperglycemia.)
Addison's disease
- Correct Answer-
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.
Sudden withdrawal of systemic corticosteroids leading to a
decrease in cortisol production from induced corticosteroid
suppression.
diabetes insipidus (DI) - Correct Answer-Insufficient ADH
or decreased sensitivity to ADH
Nephron cannot conserve water.
2
, 3
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)
- Correct Answer-Excess ADH production.
Nephron conserves excess water.
Caused by head injury and lung cancers.
Serum: Hyponatremia and hypoosmolality.
3
