A27-year-oldmancomesto the Veteran'sAdministration Hospitalat the insistence of his fiance who accompanies him to the appointment. She tells the APRN that her fiance has not "been the same" since he returned from his second tour in Iraq.He was an infantryman with a local Marine Reserve unitand served 2 tours and was honorably discharged. Since his return,he has had difficulty sleeping, and says he "sleeps with one eye open"and fears sleep. Deep sleep brings vivid nightmares. He grudgingly admitstohavingexperiencedseveraltraumatic events during his second tour of duty. He is unwilling to discuss themand will not reveal specific details. He is short temperedand irritableand is afraid to be around people as he doesn't want to snap at people and alienate them. He startles easily at loud noises, especially the sounds of cars backfiring.He admits tothinking there are threats everywhere and spends an excessive amount of time searching for them but never finding any. He has intrusive memories almost every dayand says he really isn't interested in doing much of anything. He is very worried that these symptoms areirreparablyhurtinghisrelationshipwith his fiance who he loves very much.The APRNdiagnoses himwithpost-traumaticstressdisorder (PTSD).

Question 1 of 2:

Describe the changes seen in the brain structure in patients with PTSD.

Question 2 of 2:

Briefly discuss therole glucocorticoids may have on the development of PTSD.