AGACNP AACN EXAM|POSERS AND CERTIFIED ANSWERS
2026|GRADED A+
Cushing's Syndrome/Disease - 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 - 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) - ANSWER-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) - 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.
2026|GRADED A+
Cushing's Syndrome/Disease - 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 - 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) - ANSWER-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) - 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.
