Cushing's Syndrome: NCLEX Priorities
Cortisol excess: moon face, buffalo hump, central obesity, hyperglycemia.
Cushing's is excess cortisol. NCLEX tests signs and management.
Recognition
Moon face, buffalo hump, central obesity, purple striae, hirsutism, easy bruising, HTN, hyperglycemia, immunosuppression. Most common cause: exogenous steroids.
Diagnosis
24-h urine cortisol, dexamethasone suppression test, late-night salivary cortisol.
Treatment
Taper exogenous steroids if cause. Surgery for pituitary or adrenal tumor. Medical therapy (ketoconazole) less commonly.
Post-op
Steroid replacement until HPA axis recovers. Monitor for adrenal insufficiency.
Frequently asked
Cushing's disease vs syndrome?
Disease = pituitary ACTH-secreting tumor specifically. Syndrome = any cause of cortisol excess.
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