Question

The client is admitted with Cushing's disease. Which symptoms support the diagnosis of Cushing's disease? A. Hypoglycemia and weight loss B. Increased lymphocytes and pale complexion C. Osteoporosis and a pendulous abdomen D. Decreased blood pressure and cyanosis

Short answer

A. Hypoglycemia and weight loss B. Increased lymphocytes and pale complexion C. Osteoporosis and a pendulous abdomen D. Decreased blood pressure and cyanosis Answer: C. Osteoporosis and a pendulous abdomen

Step-by-step solution

Understand Cushing's disease

Cushing's disease is a hormonal disorder caused by prolonged exposure of high levels of cortisol (a stress hormone) in the body. Some of the common symptoms of Cushing's disease include weight gain, redistribution of fat (especially in the face and upper back), thinning of the skin, easy bruising, increased susceptibility to infections, and fatigue.

Examine each option provided

We will now go through the options provided and determine which set of symptoms support the diagnosis of Cushing's disease.

Option A: Hypoglycemia and weight loss

Hypoglycemia (low blood sugar) and weight loss are not common symptoms of Cushing's disease. The disease is more typically associated with weight gain, not weight loss. Additionally, elevated cortisol levels in Cushing's disease may cause hyperglycemia (high blood sugar) instead of hypoglycemia. Therefore, option A is incorrect.

Option B: Increased lymphocytes and pale complexion

Increased lymphocytes (a type of white blood cell) and pale complexion are also not common symptoms of Cushing's disease. While cortisol can affect the immune system, the symptoms listed in this option are not specific to Cushing's disease, making option B incorrect.

Option C: Osteoporosis and a pendulous abdomen

Osteoporosis (thinning of bones) and a pendulous abdomen (a swollen, hanging belly) are common symptoms of Cushing's disease. Osteoporosis results from the increased breakdown of bone tissue due to high cortisol levels, while a pendulous abdomen is caused by the characteristic redistribution of fat associated with the disease. Therefore, option C is correct.

Option D: Decreased blood pressure and cyanosis

Decreased blood pressure and cyanosis (bluish discoloration of the skin) are not associated with Cushing's disease. While high cortisol levels can lead to an increase in blood pressure, decreased blood pressure is not a symptom of the disease. Cyanosis is also unrelated to Cushing's disease, making option D incorrect.

Conclusion

Based on our analysis of each option, the correct answer is option C, as osteoporosis and a pendulous abdomen are the symptoms that support the diagnosis of Cushing's disease.

Key concepts

Hormonal Disorder Symptoms

Hormonal disorders manifest through various symptoms, significantly affecting a person's health. Cushing's disease is a type of hormonal disorder characterized by excessive production of cortisol, a hormone released by the adrenal glands. When there's too much cortisol, it creates several physical changes and health complications. Some of the most recognizable symptoms include:

• Weight gain, particularly in the midsection and upper back.
• Round, moon-like face due to fat redistribution.
• Thinning hair and fragile skin.
• Easy bruising and delayed healing of infections.
• Muscle weakness.
• Increased likelihood of developing conditions like diabetes due to elevated blood glucose levels.

These symptoms result from the body's reaction to prolonged exposure to high levels of cortisol, disrupting normal metabolic processes in both visible and non-visible ways.
Understanding the symptoms is crucial for timely diagnosis and treatment, particularly in managing Cushing's disease.

Cortisol Levels Effects

The effects of elevated cortisol levels on the body are profound and widespread. Cortisol, often referred to as the body's stress hormone, has several roles, including regulating metabolism, reducing inflammation, and controlling the sleep-wake cycle. However, when cortisol remains elevated over long periods, it can significantly impact health.

• Metabolic Disturbance: High cortisol levels can lead to weight gain and an inability to lose weight. This hormone stimulates increased appetite and cravings for fatty, sugary foods.
• Immune System Suppression: Cortisol can weaken the immune response, making the body more susceptible to infections.
• Mood and Cognitive Effects: Chronic cortisol elevation can cause mood swings, anxiety, and depression. It can also affect memory and concentration.

By understanding these effects, medical professionals can better treat and manage conditions related to cortisol imbalances, such as Cushing's disease.
Proper management of cortisol levels is essential to mitigate these potentially harmful health implications.

Osteoporosis Education

Osteoporosis is a condition characterized by the weakening of bones, which can occur due to multiple factors, including hormonal imbalances. In Cushing's disease, elevated levels of cortisol contribute to bone demineralization, leading to osteoporosis. It is important to understand both the risks and management strategies for osteoporosis:

• Bone Health Risks: High cortisol accelerates bone resorption, the process where bone tissue is broken down, releasing minerals into the bloodstream, which weakens the bones over time.
• Prevention and Management: Adequate intake of calcium and vitamin D is critical, along with regular weight-bearing exercise to strengthen bones.
• Medications: Some patients may require medications to slow bone loss or even build new bone in severe cases.

Education about osteoporosis is an essential component of managing Cushing's disease effectively. By focusing on factors that support bone health, individuals can reduce their risk of fractures and maintain a better quality of life despite their condition.
Proactive steps in education and management can lead to better outcomes for those affected by osteoporosis related to hormonal disorders.