Cushing Syndrome

An RPN may first encounter Cushing syndrome as a medication-safety issue: a patient taking corticosteroids develops new hyperglycemia, hypertension, bruising, or difficulty climbing stairs. The same pattern can arise from endogenous cortisol excess caused by a pituitary, adrenal, or ectopic source. The findings are connected rather than incidental—cortisol alters glucose and protein metabolism, weakens skin and bone, changes immune responses, and can produce substantial potassium loss.\n\nClinical priorities are to identify every source of glucocorticoid exposure, recognize the characteristic pattern, prevent infection, thrombosis, and injury, and detect adrenal insufficiency when cortisol production is suddenly reduced. The distinction between Cushing syndrome and Cushing disease then directs the diagnostic pathway: syndrome describes the cortisol-excess state, whereas disease refers specifically to a pituitary ACTH-producing lesion.