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Question 1

How do you tell the difference between ectopic and intrinsic causes of Cushing’s?

Answer 1

1. Low dose overnight dexamethasone test used initially to diagnose Cushing’s (no supression in morning cortisol spike)
2. HIGH DOSE Dexamethasone suppression test
   - this works to suppress ACTH (exogenous steroid to suppress endogenous production)

If suppresses cortisol - pituitary cause

If not suppressed - adrenal cause (but ACTH will be suppresesd)
If ACTH not suppressed - ectopic ACTH syndrome

Question 2

What skin cancer are renal transplant pts susceptible to?

Answer 2

SCC

Question 3

If a pt has low calcium/vit D - what should be done prior to starting bisphosphanates?

Answer 3

Correct calcium/vit D levels

Question 4

What are the grades of pressure ulcers?

How are they managed?

Answer 4

Grade 1 - non-blachable erythema of INTACT skin

Grade 2 - partial thickness loss
Grade 3 - full thickness loss

Moist wound environment
Refer to tissue viability nurse