A patient with Cushing's syndrome undergoes irradiation of the ...

[jlmhmf]

A patient with Cushing's syndrome undergoes irradiation of the pituitary gland. During the months required for the irradiation to produce its effect on the pituitary gland, the patient may be treated adjunctively with
 
  a. dexamethasone.
  b. fludrocortisone acetate (Florinef).
  c. ketoconazole (Nizoral).
  d. cosyntropin.

Question 2

A nurse is at a national conference on weapons of mass destruction (WOMD). The predominant topic is smallpox. To ensure her grasp of the knowledge, the nurse goes over it in her mind.
 
  Which of the following would indicate the need for further reinforcement? a. Smallpox is caused by the variola virus.
  b. Smallpox has no proven treatment.
  c. The incubation phase is 7 to 10 days.
  d. Mortality is highest from formation of bumps to scabbing.

[milbourne11]

Answer to Question 1

C
Ketoconazole is the most effective inhibitor of glucocorticoid synthesis available.
Dexamethasone is used for replacement therapy, for treating nonendocrine disorders, and for the diagnosis of adrenal dysfunction.
Fludrocortisone acetate, a potent mineralocorticoid, is the drug of choice for chronic mineralo-corticoid replacement. It is used to treat Addison's disease and primary hypoaldosteronism.
Cosyntropin mimics the effects of human ACTH. It is not indicated for Cushing's disease, but rather is used primarily for diagnostic tests.

Answer to Question 2

C
The incubation period for smallpox is 12 to 14 days; further teaching is needed.
Smallpox is caused by the variola virus; no further teaching is needed.
No proven treatment is available for smallpox; no further teaching is needed.
Mortality is highest from the formation of bumps to scabbing because of the circulating immune complexes; no further teaching is needed.