Which of the following clinical manifestations would support the medical diagnosis of Cushing syndrome? Select all that apply
A) Excessive facial hair growth
B) Muscle hypertrophy
C) Blood glucose level in 200 mg/dL range
D) "Buffalo hump" on back
E) Blood pressure reading less than 90/70
Ans: A, C, D
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The major manifestations of Cushing syndrome represent an exaggeration of the many actions of cortisol. There is muscle weakness, and the extremities are thin. Derangements in glucose metabolism are found in approximately 75% of clients, with clinically overt diabetes mellitus occurring in approximately 20% of clients. The glucocorticoids possess mineralocorticoid properties; this causes fluid retention and hypertension resulting from sodium retention, water retention, and hypervolemia. An increase in androgen levels causes hirsutism. Altered fat metabolism causes a peculiar deposition of fat characterized by a protruding abdomen; subclavicular fat pads or "buffalo hump" on the back; and a round, plethoric "moon face."
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