Cushing Cora — Cushing's Syndrome
Moon face, buffalo hump, high Na⁺, low K⁺, high glucose
Cora takes prednisone for years and her body redistributes itself: a round face, a fatty pad at the base of her neck, and arms too thin to hold her up.
Cora has too much cortisol — usually from long-term steroids. Central obesity with thin extremities, moon face, buffalo hump, purple striae, thin skin and easy bruising. Sodium and glucose rise, potassium falls, bones thin and infections hide.
Read Cushing Cora's full story →The story arc
The setup
High-dose prednisone for rheumatoid arthritis, taken daily for three years.
The turn
Her face rounds, a fat pad grows between her shoulders, purple striae stretch across her abdomen and she bruises from a handshake.
The crisis
Glucose 268, potassium 3.1, blood pressure 168/96, and a wound on her shin has not healed in six weeks without ever looking infected.
The save
The steroid is tapered slowly, never stopped, with glucose monitoring, infection surveillance, fall precautions and a high-protein, high-calcium, low-sodium diet.
NCLEX study section — Cushing's Syndrome
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Endocrine & Metabolic
Take this chapter into practice questions on the same topic.