Which change would the nurse expect to find in a patient with hypercortisolism upon physical assessment?

Which change would the nurse expect to find in a patient with hypercortisolism upon physical assessment?

• A. Presence of fat pads on the shoulders
• B. Pitting edema in the ankles
• C. Jaundice
• D. Hyperpigmentation of the skin

Answer: (A)

Excess cortisol changes fat distribution, producing central obesity and distinctive dorsocervical fat pads known as a buffalo hump. The presence of fat pads on the shoulders/back of the neck is a classic physical finding in hypercortisolism because cortisol promotes fat deposition in that region while other tissues (like skin and muscle) become thinner or weaker. Other options don’t fit the typical picture: pitting edema can occur with many conditions but isn’t specific to hypercortisolism; jaundice indicates liver or biliary disease rather than cortisol excess; hyperpigmentation is more associated with high ACTH states (like Addison’s disease) and isn’t a hallmark of Cushing syndrome.

Excess cortisol changes fat distribution, producing central obesity and distinctive dorsocervical fat pads known as a buffalo hump. The presence of fat pads on the shoulders/back of the neck is a classic physical finding in hypercortisolism because cortisol promotes fat deposition in that region while other tissues (like skin and muscle) become thinner or weaker.

Other options don’t fit the typical picture: pitting edema can occur with many conditions but isn’t specific to hypercortisolism; jaundice indicates liver or biliary disease rather than cortisol excess; hyperpigmentation is more associated with high ACTH states (like Addison’s disease) and isn’t a hallmark of Cushing syndrome.