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Can Systemic Steroids Be Linked to Changes in Brain Structure?

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  1. You are a member of the healthcare team seeing a 60-year-old woman for symptoms of cognitive impairment. She has been treated frequently with systemic glucocorticoids for nearly 15 years because of severe rheumatoid arthritis. What should you consider regarding the use of glucocorticoids and brain health?
    Glucocorticoids can increase the risk for depression, but not delirium
    Glucocorticoids can increase the risk for suicide attempt, but not mania
    Cushing disease is associated with brain edema
    High-dose glucocorticoids may reduce the volume of the hippocampus and amygdala
  2. According to the results of the current study by van der Meulen and colleagues, which one of the following outcomes is most likely to be worse for this patient based on her use of systemic glucocorticoids?
    Brain inflammation
    Total brain volume
    Risk for stroke