A 50-year-old male patient presents with facial rounding, central obesity, and purple striae on the abdomen. Laboratory results show high levels of ACTH. What is the most likely underlying cause of his condition?
Adrenal insufficiency.
Pheochromocytoma.
Cushing Disease.
Hyperthyroidism.
The Correct Answer is C
Choice A Reason:
Adrenal insufficiency, also known as Addison’s disease, is characterized by insufficient production of cortisol and aldosterone by the adrenal glands. Symptoms typically include fatigue, weight loss, low blood pressure, and hyperpigmentation of the skin. High levels of ACTH are not associated with adrenal insufficiency; instead, ACTH levels are usually elevated in response to low cortisol levels.
Choice B Reason:
Pheochromocytoma is a rare tumor of the adrenal gland that produces excess catecholamines, leading to symptoms such as hypertension, palpitations, and headaches. It does not cause high levels of ACTH or the physical manifestations described in the patient, such as facial rounding and purple striae.
Choice C Reason:
Cushing Disease is caused by a pituitary adenoma that secretes excess adrenocorticotropic hormone (ACTH), leading to overproduction of cortisol by the adrenal glands. This results in symptoms such as facial rounding (moon face), central obesity, purple striae on the abdomen, and high levels of ACTH. These clinical features align with the patient’s presentation, making Cushing Disease the most likely underlying cause.
Choice D Reason:
Hyperthyroidism is characterized by excessive production of thyroid hormones, leading to symptoms such as weight loss, heat intolerance, palpitations, and tremors. It does not cause high levels of ACTH or the specific physical changes seen in Cushing Disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Increased appetite is not typically associated with anemia. Anemia generally leads to symptoms related to decreased oxygen-carrying capacity of the blood, such as fatigue, weakness, and shortness of breath. Increased appetite is more commonly linked to other conditions, such as hyperthyroidism or certain metabolic disorders.
Choice B Reason:
Fatigue is a common and significant symptom of anemia. When hemoglobin levels are low, the body’s tissues do not receive adequate oxygen, leading to feelings of tiredness and exhaustion. This is because hemoglobin is responsible for transporting oxygen from the lungs to the rest of the body. In anemia, the reduced oxygen delivery results in decreased energy levels and persistent fatigue.
Choice C Reason:
Weight gain is not typically associated with anemia. In fact, some forms of anemia, such as those caused by chronic diseases or malnutrition, may lead to weight loss rather than gain. Weight gain can be associated with other health issues, such as hypothyroidism or fluid retention, but not directly with anemia.
Choice D Reason:
Hypertension is not a common manifestation of anemia. Anemia usually leads to symptoms like pallor, shortness of breath, and fatigue due to the reduced oxygen-carrying capacity of the blood. Hypertension, or high blood pressure, is more commonly associated with cardiovascular diseases, kidney disorders, or endocrine conditions.
Correct Answer is D
Explanation
Choice A Reason:
Macular degeneration primarily affects central vision and is characterized by a gradual loss of vision rather than sudden symptoms. It does not typically cause flashes of light, shadows over the visual field, or floaters. These symptoms are more indicative of a retinal issue.
Choice B Reason:
Cataracts cause clouding of the lens, leading to blurred vision and difficulty seeing at night. However, they do not cause sudden flashes of light, shadows over the visual field, or floaters. Cataracts develop gradually and do not present with acute symptoms.
Choice C Reason:
Glaucoma is associated with increased intraocular pressure, which can lead to gradual loss of peripheral vision. While acute angle-closure glaucoma can cause sudden symptoms, it typically presents with severe eye pain, headache, and nausea, rather than flashes of light and floaters.
Choice D Reason:
Retinal detachment is characterized by the sudden onset of flashes of light, floaters, and a shadow or curtain over the visual field. These symptoms occur because the retina is pulling away from its normal position, which can lead to vision loss if not treated promptly. Immediate medical attention is required to prevent permanent vision loss.
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