Cushing's syndrome is associated with -

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

Cushing's syndrome is a hormonal disorder defined by prolonged exposure to high levels of glucocorticoids.
The primary glucocorticoid involved is cortisol, often referred to as the body's main stress hormone.
This excess can be iatrogenic (caused by external steroid medications) or endogenous (caused by the body's overproduction, often from tumors).
The oversecretion of glucocorticoids directly leads to the classic signs of the syndrome, such as central obesity, moon face, and metabolic changes.

Option A: Insulin's primary role is to regulate blood glucose. While Cushing's syndrome can lead to hyperglycemia (high blood sugar), insulin itself is not the causative hormone of the syndrome. Insulin excess causes hypoglycemia.
Option B: Excess growth hormone does not cause Cushing's syndrome. It leads to different conditions characterized by overgrowth of tissues.
Option D: Calcitonin is produced by the thyroid gland and is involved in calcium and phosphate metabolism. It has no association with the pathophysiology of Cushing's syndrome.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology of Cushing's Syndrome helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must be vigilant in assessing patients on long-term corticosteroid therapy for the signs of iatrogenic Cushing's syndrome.
Patient education is a critical nursing role, emphasizing the importance of not stopping steroid medications abruptly to prevent a life-threatening adrenal crisis.
Key nursing interventions include monitoring vital signs for hypertension, checking blood glucose for hyperglycemia, and assessing for signs of infection, as high cortisol levels suppress the immune system.

How to Approach the Question

This is a factual recall question testing knowledge of the endocrine system.
First, identify the core concept in the question stem: 'Cushing's syndrome'.
Access your knowledge about this specific endocrine disorder. Recall its definition, the gland involved (adrenal gland), and the primary hormone responsible.
Systematically evaluate each option by linking the hormone to its primary function and associated gland.
Option A (Insulin) is from the pancreas and regulates glucose.
Option B (Growth hormone) is from the pituitary and regulates growth.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 36-38

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 543-545

E6 Medicine Harrison 22e Part 1 p. 778-780

Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.