In a 29-year-old female client who is being successfully treated for Cushing’s syndrome, nurse Lyzette would expect a decline in:
A. Serum glucose level
B. Hair loss
C. Bone mineralization
D. Menstrual flow
Correct Answer: A. Serum glucose level
Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing’s syndrome. With successful treatment of the disorder, serum glucose levels decline. Cortisol is a steroid hormone, and it directly affects the transcription and translation of enzyme proteins involved in the metabolism of fats, glycogen, proteins synthesis, and Kreb’s cycle. It promotes the production of free glucose in the body, elevating glucose levels, while simultaneously increasing insulin resistance.
Option B: Hirsutism is common in Cushing’s syndrome; therefore, with successful treatment, abnormal hair growth also declines. Cushing syndrome depends on adrenocorticotropic hormone (ACTH). It can cause hirsutism, because of the stimulating nature of ACTH on the reticulated area that can cause excessive androgen secretion. The features of hypercorticism are often in the foreground.
Option C: Osteoporosis occurs in Cushing’s syndrome; therefore, with successful treatment, bone mineralization increases. It has been well known that patients with Cushing’s syndrome have frequently osteoporosis or bone loss due to excess endogenous glucocorticoids and also osteopenia or osteoporosis is commonly observed in patients with long-term glucocorticoid therapy.
Option D: Amenorrhea develops in Cushing’s syndrome. With successful treatment, the client experiences a return of menstrual flow, not a decline in it. In Cushing’s disease, amenorrhea is typically due to increased circulating androgens produced by the adrenal gland and cortisol can suppress GnRH and therefore LH and FSH pulsatility.
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