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Patient case: Cushing’s Syndrome

Patient case: Cushing’s Syndrome

Discussion

A 45-year-old woman presents with a 6-month history of progressive weight gain, particularly in her face and abdomen, along with increasing fatigue and muscle weakness. She reports developing purple stretch marks on her abdomen and easy bruising with minor trauma. On examination, she has a rounded "moon face," central obesity, thin skin, and proximal muscle weakness. Blood pressure is elevated at 150/95 mmHg. Laboratory tests reveal elevated cortisol levels, and a dexamethasone suppression test confirms the diagnosis of Cushing’s syndrome. Imaging shows an adrenal adenoma.

Diagnosis: Cushing’s Syndrome

Treatment Plan: Surgery to remove the adrenal adenoma was recommended, along with blood pressure management and lifestyle modifications.

Questions
1. What is the most likely diagnosis for the patient’s symptoms of weight gain, "moon face," and proximal muscle weakness?

A) Hypothyroidism

B) Cushing’s Syndrome

C) Diabetes Mellitus

D) Hyperthyroidism

2. Which of the following diagnostic tests confirmed the diagnosis of Cushing’s syndrome in this patient?

A) Fasting glucose test

B) Dexamethasone suppression test

C) Ultrasound of the abdomen

D) MRI of the brain

3. What is the most appropriate treatment for this patient's Cushing’s syndrome caused by an adrenal adenoma?

A) Long-term corticosteroid therapy

B) Surgical removal of the adrenal adenoma

C) Radiation therapy

D) Antihypertensive medications only

4. Which of the following symptoms is most commonly associated with Cushing’s syndrome?

A) Cold intolerance

B) Central obesity

C) Decreased appetite

D) Hypotension

Reveal answers

Answers

1. B) Cushing’s Syndrome

2. B) Dexamethasone suppression test

3. B) Surgical removal of the adrenal adenoma

4. B) Central obesity