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A nursing student asks whether there is a difference between Cushing's disease versus Cushing's syndrome. Which laboratory value can help differentiate Cushing's disease from Cushing's syndrome?

A. Elevated adrenocorticotropic hormone (ACTH)
B. Elevated cortisol
C. Decreased cortisol
D. Elevated epinephrine

1 Answer

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Final answer:

Elevated adrenocorticotropic hormone (ACTH) levels can differentiate Cushing's disease, which involves a pituitary tumor, from other forms of Cushing's syndrome that may exhibit normal or decreased ACTH levels.

Step-by-step explanation:

Difference Between Cushing's Disease and Cushing's Syndrome

The laboratory value that can help differentiate Cushing's disease from Cushing's syndrome is elevated adrenocorticotropic hormone (ACTH). Cushing's syndrome involves the hypersecretion of cortisol, which can result from various causes, including a pituitary tumor (Cushing's disease), an adrenal tumor, or ectopic ACTH production by non-pituitary tumors.

Elevated cortisol levels are common to both conditions, so this measurement alone cannot differentiate them.

However, Cushing's disease, which is specifically caused by a pituitary tumor, results in increased ACTH levels as the pituitary gland secretes excessive ACTH that stimulates the adrenal glands to produce more cortisol.

In contrast, other forms of Cushing's syndrome may show normal or low ACTH levels if caused by an adrenal tumor or exogenous glucocorticoid use. Therefore, measuring ACTH levels can be diagnostically significant.

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