AACN AGACNP Review 2023/2024 updated to pass

AACN AGACNP Review Cushing's Syndrome/Disease - correct answer cortisol 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 answer Primary 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 answer Insufficient 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 answer Excess 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: