The clinical manifestations of Cushing's syndrome are?

Appeared in: Daman & Diu Staff Nurse - 2018

Explanation

Cushing's syndrome is caused by prolonged exposure to excess cortisol.
A primary effect of excess cortisol is the redistribution of adipose tissue.
This leads to the classic signs of fat accumulation in the face (moon facies) and abdomen (truncal obesity), while the limbs may become thin from muscle wasting.

Why Other Options Were Wrong

Option B: Cushing's syndrome causes hypertension (high blood pressure) due to sodium and water retention from the mineralocorticoid effects of cortisol.
Option C: Cushing's syndrome causes hypokalemia (low potassium) because excess cortisol promotes urinary excretion of potassium.
Option D: Patients with Cushing's syndrome typically experience weight gain and an increased appetite due to the metabolic effects of cortisol.

Related Visual

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of Cushing's syndrome helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must closely monitor patients with Cushing's syndrome for complications such as severe hypertension, hyperglycemia leading to diabetes, and life-threatening infections due to immunosuppression.
Patient safety involves protecting them from falls due to muscle weakness and osteoporosis, and providing meticulous skin care for their fragile, easily bruised skin.
What if? If a patient presents with rapid weight loss, low blood pressure, and hyperpigmentation (darkening of the skin), the priority would be to investigate for Addison's disease, the opposite condition, which requires immediate cortisol replacement.

How to Approach the Question

First, identify the core concept of the question, which is the clinical presentation of Cushing's syndrome.
Recall that Cushing's syndrome is a state of 'too much cortisol'.
Think about the main functions of cortisol and what happens when they are exaggerated: it affects fat storage, blood pressure, electrolytes, and blood sugar.
Evaluate each option based on these effects. 'Moon facies' and 'truncal obesity' are the most well-known signs related to cortisol's effect on fat distribution.
Recognize that the other options—hypotension, hyperkalemia, and weight loss—are symptoms of 'too little cortisol', which is Addison's disease. This contrast helps confirm the correct answer and eliminate the distractors.

Concept Tested & Keywords

Concept Tested: Clinical manifestations of Cushing's syndrome
Stem keywords: Cushing's syndrome, clinical manifestations
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

Question ID

Q6okddPL7BKQCOnIv107k2

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 43-45

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 7497-7499

E6 Medicine Harrison 22e Part 2 p. 915-917

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