A 35-year-old woman presents with fatigue, weakness, and weight gain. Her blood pressure is 155/90 mm Hg, pulse 80/min, and there is central obesity with skin striae. Investigations are shown in Table given below. Which of the following is the most likely diagnosis?Table given below is the case work-up NormalPatientPlasma ACTH pg/mL< 150< 50Plasma cortisol m/dL1735Urine 17-OH mg/24 h2 to 1025Urine 17-Ks mg/24 h5 to 1510Urine 17-OH response to:ACTH IVIncreasex5No responseDexamethasone 0.5 mg< 3.0No response2.0 mg< 3.0No responseMetyrapone 750 mgIncreasex 2No responseAbbreviation: ACTH–adrenocorticotropic hormone
Correct Answer: adrenal adenoma with complete autonomy
Description: Autonomous adrenal tumors are adrenocorticotropic hormone (ACTH) insensitive and fail to demonstrate a brisk rise in urinary 17-hydroxycorticoids. Androgenic effects, such as hirsutism, are usually absent. In Cushing's syndrome, secondary to an autonomous adrenal tumor, onset is usually gradual, and hirsutism, other androgenic effects, and hyperpigmentation are absent.
Category:
Medicine
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now