NURS 4020 EXAM 1 QUESTIONS AND ANSWERS
Cushing's Syndrome (hypercotrisolism) pathophysiology - CORRECT ANSWER✅✅Excessive tissue
exposure to cortisol either from excessive secretion or excessive glucocorticoid use
Which conditions cause endogenous secretion of cortisol in Cushing's? - CORRECT ANSWER✅✅-
bilateral adrenal hyperplasia (of the pituitary gland)
-pituitary adenoma increasing production of ACTH
-carcinomas of lung, GI tract, or pancreas
What is ACTH? - CORRECT ANSWER✅✅adrenocorticotropic hormone, makes cortisol
What conditions would cause the use of glucocorticoids that could potentially lead to cushing's? -
CORRECT ANSWER✅✅-Asthma
-Autoimmune disorders
-chemo
-allergies
-Chronic fibrosis
-Organ transplants
Addison's Disease (adrenal insufficiency) pathophysiology - CORRECT ANSWER✅✅Hypofunction of the
adrenal gland resulting from inadequate secretion of adrenocorticotropic hormone (ACTH) resulting in a
deficiency of cortisol. The cortisol supply doesn't meet demand
Primary causes of Addision's - CORRECT ANSWER✅✅-Autoimmune disorders (especially AIDS)
-TB
-Sepsis
-Adrenalectomy
-Metastic cancer
,Secondary causes of Addison's disease - CORRECT ANSWER✅✅-Abrupt withdrawal from long-term,
high dose steroids
-Pituitary tumors
-Postpartum pituitary necrosis
-hypophysectomy
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) pathophysiology - CORRECT
ANSWER✅✅Increase ADH production makes the kidney tubules more permeable to water causing
higher water reabsortion rates. Increased water reabsorption causes hypervolemia, and dilutional
hyponatremia
Diabetes Insipidius (DI) (aka Arginine Vasopressin Deficiency/resistance AVP-D, AVP-R) Pathophysiology -
CORRECT ANSWER✅✅A lack of ADH causes kidneys to be unable to concentrate on urine or retain
water, causing a greater proportion of water to be excreted compared to solutes including sodium
Most common cause of Addison's disease? - CORRECT ANSWER✅✅AIDS
Which cortisol imbalance is worsened by stress? Why? - CORRECT ANSWER✅✅-Adrenal insufficiency/
Addison's disease
-Demand for cortisol increases
Which disease has high serum and salivary cortisol? - CORRECT ANSWER✅✅Cushing's disease
(hypercortisolism)
Which disease has low serum and salivary cortisol? - CORRECT ANSWER✅✅Addisons's Disease (Adrenal
Insufficiency)
Does Cushing's have high or low aldosterone? - CORRECT ANSWER✅✅↑ High
Does Cushing's have high or low sodium? - CORRECT ANSWER✅✅↑ High
,Does Cushing's have high or low potassium? - CORRECT ANSWER✅✅↓ Low
Does Cushing's have high or low blood pressure? - CORRECT ANSWER✅✅↑ High
Does Cushing's have high or low BUN? - CORRECT ANSWER✅✅↑ High
Which acid-base imbalance does Cushing's cause? - CORRECT ANSWER✅✅Alkalosis
Does Cushing's have high or low HCO3 - CORRECT ANSWER✅✅↑ High (alkaline)
Does Cushing's have high or low blood glucose - CORRECT ANSWER✅✅↑ High
What does the skin of a person with Cushings look like? - CORRECT ANSWER✅✅-Thin/fragile
-dependent edema
-bruising
-petechiae
-striae
Which hormone imbalance causes skin that is thin/fragile, has dependent edema, bruising, striae, and
petechiae? - CORRECT ANSWER✅✅Cushing's
What psychosocial symptom is seen in patient's with cushings? - CORRECT ANSWER✅✅Emotional
instability
Is appetite increased or decreased with Cushing's patients? - CORRECT ANSWER✅✅Increased
What are visual cues of a persons with Cushing's? - CORRECT ANSWER✅✅-Moon face
-Truncal Obesity
-Buffalo hump
, Which hormone disorder is associated with truncal obesity, moon face, and buffalo hump? - CORRECT
ANSWER✅✅Cushing's
How does Cushing's effect the immune response? - CORRECT ANSWER✅✅Decreases it due to causing
low lymphocytes
How does Cushing's effect other hormones? - CORRECT ANSWER✅✅-High androgens
-Low ovarian hormones
What is the effect of Cushing's on bone health - CORRECT ANSWER✅✅Causes osteoperosis
Cushing's interventions - CORRECT ANSWER✅✅-Reducing corticosteroid use
-Bilateral adrenalectomy
-Radiation therapy
-Medications
What medications are used to control excessive production of cortisol at the adrenal gland? - CORRECT
ANSWER✅✅-ketoconazole
-mitotane
-metryrapone
Patient teaching for adrenalectomies - CORRECT ANSWER✅✅-After procedure life long cortisol
replacement therapy will be necessary
-Increase vitamin D and calicum to increase bone density
-decrease sodium
-No caffiene or alcohol
-Take weight daily
Cushing's Syndrome (hypercotrisolism) pathophysiology - CORRECT ANSWER✅✅Excessive tissue
exposure to cortisol either from excessive secretion or excessive glucocorticoid use
Which conditions cause endogenous secretion of cortisol in Cushing's? - CORRECT ANSWER✅✅-
bilateral adrenal hyperplasia (of the pituitary gland)
-pituitary adenoma increasing production of ACTH
-carcinomas of lung, GI tract, or pancreas
What is ACTH? - CORRECT ANSWER✅✅adrenocorticotropic hormone, makes cortisol
What conditions would cause the use of glucocorticoids that could potentially lead to cushing's? -
CORRECT ANSWER✅✅-Asthma
-Autoimmune disorders
-chemo
-allergies
-Chronic fibrosis
-Organ transplants
Addison's Disease (adrenal insufficiency) pathophysiology - CORRECT ANSWER✅✅Hypofunction of the
adrenal gland resulting from inadequate secretion of adrenocorticotropic hormone (ACTH) resulting in a
deficiency of cortisol. The cortisol supply doesn't meet demand
Primary causes of Addision's - CORRECT ANSWER✅✅-Autoimmune disorders (especially AIDS)
-TB
-Sepsis
-Adrenalectomy
-Metastic cancer
,Secondary causes of Addison's disease - CORRECT ANSWER✅✅-Abrupt withdrawal from long-term,
high dose steroids
-Pituitary tumors
-Postpartum pituitary necrosis
-hypophysectomy
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) pathophysiology - CORRECT
ANSWER✅✅Increase ADH production makes the kidney tubules more permeable to water causing
higher water reabsortion rates. Increased water reabsorption causes hypervolemia, and dilutional
hyponatremia
Diabetes Insipidius (DI) (aka Arginine Vasopressin Deficiency/resistance AVP-D, AVP-R) Pathophysiology -
CORRECT ANSWER✅✅A lack of ADH causes kidneys to be unable to concentrate on urine or retain
water, causing a greater proportion of water to be excreted compared to solutes including sodium
Most common cause of Addison's disease? - CORRECT ANSWER✅✅AIDS
Which cortisol imbalance is worsened by stress? Why? - CORRECT ANSWER✅✅-Adrenal insufficiency/
Addison's disease
-Demand for cortisol increases
Which disease has high serum and salivary cortisol? - CORRECT ANSWER✅✅Cushing's disease
(hypercortisolism)
Which disease has low serum and salivary cortisol? - CORRECT ANSWER✅✅Addisons's Disease (Adrenal
Insufficiency)
Does Cushing's have high or low aldosterone? - CORRECT ANSWER✅✅↑ High
Does Cushing's have high or low sodium? - CORRECT ANSWER✅✅↑ High
,Does Cushing's have high or low potassium? - CORRECT ANSWER✅✅↓ Low
Does Cushing's have high or low blood pressure? - CORRECT ANSWER✅✅↑ High
Does Cushing's have high or low BUN? - CORRECT ANSWER✅✅↑ High
Which acid-base imbalance does Cushing's cause? - CORRECT ANSWER✅✅Alkalosis
Does Cushing's have high or low HCO3 - CORRECT ANSWER✅✅↑ High (alkaline)
Does Cushing's have high or low blood glucose - CORRECT ANSWER✅✅↑ High
What does the skin of a person with Cushings look like? - CORRECT ANSWER✅✅-Thin/fragile
-dependent edema
-bruising
-petechiae
-striae
Which hormone imbalance causes skin that is thin/fragile, has dependent edema, bruising, striae, and
petechiae? - CORRECT ANSWER✅✅Cushing's
What psychosocial symptom is seen in patient's with cushings? - CORRECT ANSWER✅✅Emotional
instability
Is appetite increased or decreased with Cushing's patients? - CORRECT ANSWER✅✅Increased
What are visual cues of a persons with Cushing's? - CORRECT ANSWER✅✅-Moon face
-Truncal Obesity
-Buffalo hump
, Which hormone disorder is associated with truncal obesity, moon face, and buffalo hump? - CORRECT
ANSWER✅✅Cushing's
How does Cushing's effect the immune response? - CORRECT ANSWER✅✅Decreases it due to causing
low lymphocytes
How does Cushing's effect other hormones? - CORRECT ANSWER✅✅-High androgens
-Low ovarian hormones
What is the effect of Cushing's on bone health - CORRECT ANSWER✅✅Causes osteoperosis
Cushing's interventions - CORRECT ANSWER✅✅-Reducing corticosteroid use
-Bilateral adrenalectomy
-Radiation therapy
-Medications
What medications are used to control excessive production of cortisol at the adrenal gland? - CORRECT
ANSWER✅✅-ketoconazole
-mitotane
-metryrapone
Patient teaching for adrenalectomies - CORRECT ANSWER✅✅-After procedure life long cortisol
replacement therapy will be necessary
-Increase vitamin D and calicum to increase bone density
-decrease sodium
-No caffiene or alcohol
-Take weight daily
