A nurse assessing for Cushing's syndrome would expect which of the following fat distribution patterns?

• A. Hypotension
• B. Thick, coarse skin
• C. Deposits of adipose tissue in the trunk and dorsocervical area
• D. Weight gain in arms and legs

Answer: (C)

Excess cortisol redistributes fat to the trunk and upper back, creating central obesity with a dorsocervical fat pad (the buffalo hump). This trunk-dorsocervical pattern is the hallmark you’d expect in Cushing's syndrome and explains why deposits in the trunk and dorsocervical area are the best match for the described fat distribution.

Other ideas don’t fit the pattern as neatly: hypotension isn’t the defining fat distribution feature (hypertension is more typical with cortisol excess). Thick, coarse skin isn’t characteristic because Cushing’s usually causes thinning of the skin with easy bruising and purple striae. Weight gain in the arms and legs would be unusual, since the limbs tend to be relatively slender or wasted due to protein breakdown and redistribution of fat toward the trunk and dorsocervical region.