BRAINSCAPE1
AACN AGACNP Review Exam with
complete solutions latest version
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.
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.
BRAINSCAPE1
, BRAINSCAPE1
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.
Urine: Hypernatremia and hyperosmolarity.
Fluid overload.
Treat with:
Free water restriction
Loop diuretic and NS
IN extremes 3% saline
Transudate pleural effusion - CORRECT ANSWER-CHF
Constrictive pericarditis
Cirrhosis
SG <1.015
Protein <3 g/dl
LDH < 200
Fluid-serum protein ratio <0.5
Fluid -serum LDH ratio <0.5
Exudate pleural effusion - CORRECT ANSWER-Lung parenchymal infection
Malignancy
PE
SG >1.015
Protein >3 g/dl
LDH >200
Fluid-serum protein ratio >0.5
Fluid-serum LDH ratio >0.5
BRAINSCAPE1
AACN AGACNP Review Exam with
complete solutions latest version
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.
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.
BRAINSCAPE1
, BRAINSCAPE1
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.
Urine: Hypernatremia and hyperosmolarity.
Fluid overload.
Treat with:
Free water restriction
Loop diuretic and NS
IN extremes 3% saline
Transudate pleural effusion - CORRECT ANSWER-CHF
Constrictive pericarditis
Cirrhosis
SG <1.015
Protein <3 g/dl
LDH < 200
Fluid-serum protein ratio <0.5
Fluid -serum LDH ratio <0.5
Exudate pleural effusion - CORRECT ANSWER-Lung parenchymal infection
Malignancy
PE
SG >1.015
Protein >3 g/dl
LDH >200
Fluid-serum protein ratio >0.5
Fluid-serum LDH ratio >0.5
BRAINSCAPE1
