Sie sind auf Seite 1von 6

Classical Symptoms

Clinical Symptoms

Rationale Related to alterations in fat deposition. The exact mechanism responsible is not known.

Moderate central obesity

manifested

Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1426

Atypical fat distribution usually involves the trunk especially the cervicodorsal region, supraclavicular areas and abdomen. Buffalo hump manifested Source: Medical Surgical Nursing Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1426 Fat also distributes about the face, in the cheeks and under the skin imparting a round and plethoric appearance. Moon face manifested Source:

Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1427 Muscular weakness, predominantly in the muscles of the pelvic girdle and extremities, secondary to loss of muscle mass maybe experienced and is a result of increased protein catabolism. Muscular weakness manifested Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1427 Caused by weakening of the collagenous fibers in and under the skin. Protein wasting also takes a toll on blood vessels. Capillary fragility leads to an increased tendency toward bruising and hematoma formation. manifested Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1427

Pink and purplish striae (on abdomen, breast, buttocks and axillae)

Protein wasting also takes a toll on blood vessels. Capillary fragility leads to an increased tendency toward bruising and hematoma formation. Echymosis, small bruises manifested Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1427 The mineralocorticoid activity of cortisol excess promotes renal retention of sodium and water. This expansion of extracellular volume is one of the causes of observed high blood pressure. High blood pressure manifested Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1427-1428 Peptic ulcers may form because cortisol excesses promote acidic gastric secrations and pepsin production. Because cortisol also inhibits gastric mucus production, susceptibility to ulcer formation is increased. Peptic ulcers manifested Source: Medical Surgical Nursing, Pathophysiological Concepts

2nd ed. By Maxine L. Patrick pg. 1427 Cortisol is thought to increase calcium resorption from the bone and inhibit collagen synthesis, thus interfering with bone formation and replenishment. Osteoporosis Not manifested Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1428 Virilization (hirsutism, thinning scalp hair, acne, decreased libido, an enlarged clitoris, and menstrual changes) May be seen in women as a result of increased androgen secretion. Not manifested Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1428 Sometimes patients are admitted first to psychiatric unit during exacerbations of their disease. The cause of the exacerbations is unknown but appears to relate to increased circulating levels of cortisol and ACTH. Some emotional instability may be the patients response to altered body image and decreased self-esteem. Frank psychosis Not manifested

Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1428 RBC and granulocyte counts may be elevated. Lymphopenia and a decrease in eosinophils may also be observed. Hypokalemia occurs in 20% of cases, because cortisol promotes potassium excretion in the renal tubules. Increased plasma cortisol levels, with loss of normal diurnal variations, along with elevated urinary levels of steroids metabolites are always seen. Hematological changes Not manifested Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick pg. 1428 Increased hepatic glucogenesis and impaired insulin use results in postprandial hyperglycemia and occasionally frank diabetes mellitus with all of its signs and symptoms. Altered carbohydrate metabolism manifested Source: Medical Surgical Nursing, Pathophysiological Concepts 2nd ed. By Maxine L. Patrick

pg. 1428