A 30-year-old woman has prominent cervical and dorsal fat pads, hirsutism, acne, purple abdominal striae, unexplained hypokalemia, and diabetes mellitus.Select the most likely disease process for the clinical syndromes described
Correct Answer: Cushing disease
Description: Cushing disease produces hypercortisolism secondary to excessive secretion of pituitary ACTH. It often affects women in their childbearing years. Prominent cervical fat pads, purple striae, hirsutism, and glucose intolerance are characteristic features, as well as muscle wasting, easy bruising, amenorrhea, and psychiatric disturbances. Diabetes mellitus can result from chronic hypercortisolism Exogenous glucocorticoid use will produce cervical fat pads, purple striae, muscle wasting, easy bruising, and secondary diabetes mellitus. Since, however, most oral glucocorticoids (e.g., prednisone, dexamethasone) have little mineralocorticoid and no androgenic effect, hypokalemia and hirsutism are rare.
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