護理師正在評估一位庫欣氏症候群（Cushing syndrome）病人。應預期觀察到哪些徵象？（選所有適合的）
A nurse is assessing a client with Cushing syndrome. Which findings should the nurse expect to observe? (Select all that apply.)
- APurple striae on the abdomen✓ 正解腹部出現紫色紋路
- BBuffalo hump✓ 正解水牛肩
- CHyperpigmentation of the skin皮膚色素沉著
- DMuscle wasting in the extremities✓ 正解四肢肌肉萎縮
- EHypotension低血壓
庫欣氏症候群是皮質醇（Cortisol）過多導致的臨床特徵。皮質醇會促進脂肪重新分布，導致軀幹肥胖、水牛肩（B）和月亮臉。它也會抑制膠原蛋白合成，造成皮膚變薄、出現紫紅色萎縮紋（A）。同時，皮質醇會加速蛋白質分解，導致四肢肌肉萎縮（D）與虛弱。選項 C（皮膚色素沉著）主要見於原發性腎上腺皮質功能不全（Addison's disease），是因為 ACTH 代償性升高同時刺激了黑素細胞；而在一般的庫欣氏症候群（特別是外源性或腎上腺來源）中較少見。選項 E 錯誤，庫欣氏症候群常伴隨水鈉滯留與高血壓，而非低血壓。掌握皮質醇對代謝的廣泛影響是作答關鍵。
Cushing's syndrome is the clinical picture resulting from excessive cortisol. Cortisol promotes fat redistribution, causing truncal obesity, buffalo hump (B), and moon face. It also suppresses collagen synthesis, leading to thinning of the skin with the appearance of purplish atrophic striae (A). At the same time, cortisol accelerates protein breakdown, producing muscle atrophy and weakness in the extremities (D). Option C (skin hyperpigmentation) is mainly seen in primary adrenocortical insufficiency (Addison's disease), in which a compensatory rise in ACTH simultaneously stimulates melanocytes; it is uncommon in ordinary Cushing's syndrome (especially exogenous or adrenal in origin). Option E is incorrect: Cushing's syndrome is often accompanied by sodium and water retention and hypertension, not hypotension. Mastering the broad effects of cortisol on metabolism is the key to answering this question.
美國護理教育非常強調 Cushing 與 Addison 的對比（Up vs Down），考題常混合兩者徵象考鑑別診斷；台灣護理執照考試也常考此主題，但較多側重在藥物引發的類固醇副作用衛教。