AACN AGACNP Review|COMPLETE STUDY GUIDE WITH DETAILED QUESTIONS AND 100% VERIFIED ANSWERS

Cushing's Syndrome/Disease - CORRECT ANSWERS️️cortisol 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 ANSWERS️️Primary 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 ANSWERS️️Insufficient 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) - CORRECT ANSWERS️️Excess 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 ANSWERS️️CHF 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 ANSWERS️️Lung 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 Fibrinolysis Contraindications - CORRECT ANSWERS️️Absolute Hx of cerebrovascular event (ICH, intracranial neoplasm, aneurysm, AVM) Non-hemorrhagic stroke or head trauma 3 months ago. Cranial or spinal trauma 2 months ago. Known bleeding disorder. Active internal bleeding. Relative Hx of severe/poorly controlled HTN or severe, uncontrolled arterial HTN SBP180 and DBP 110 Ischemic stroke 3 months ago. Trauma or major surgery in the last 3 weeks. Puncture of a non-compressible vessel.