Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

What condition might be indicated by a moon-shaped face, obese trunk, and thin extremities noted during a preoperative assessment?

1. Lobstein's disease

2. Cushing's disease

3. Kearns-Sayre disease

4. Klippel-fell syndrome

The correct answer is: Cushing's disease

The presence of a moon-shaped face, an obese trunk, and thin extremities during a preoperative assessment is characteristic of Cushing's disease. This condition arises from an excess of cortisol in the body, often due to a tumor in the pituitary gland that produces adrenocorticotropic hormone (ACTH) leading to increased cortisol production by the adrenal glands. Patients with Cushing's disease typically exhibit a range of physical changes attributed to the hormonal imbalance, including the distinct roundness of the face (known as "moon facies"), the accumulation of fat in the trunk area, and a disproportionate appearance with thinner extremities. These physical signs are a direct manifestation of the alterations in fat distribution and muscle tissue that occur in response to elevated cortisol levels. Other conditions listed do not feature the same combination of symptoms. For instance, Lobstein's disease is more associated with osteogenesis imperfecta and brittle bone issues, while Kearns-Sayre syndrome involves cardiac and ocular problems alongside neuromuscular features. Klippel-Feil syndrome affects the cervical spine and results in restricted neck movement without the obesity pattern seen in Cushing's disease. Thus, the symptoms noted in the question align most closely with Cushing's disease