All of the following are clinical features of Cushing’s syndrome EXCEPT: March 2004
## **Core Concept**
Cushing's syndrome is a clinical condition caused by excess levels of cortisol in the body. This can result from various etiologies, including exogenous steroid use, ACTH-producing pituitary adenomas, adrenal tumors, and familial Cushing's syndrome. The manifestations of Cushing's syndrome are diverse and affect multiple systems.
## **Why the Correct Answer is Right**
To accurately answer this question, we need to know the common clinical features of Cushing's syndrome, which include weight gain (particularly in the central part of the body), thinning of the skin, poor wound healing, muscle weakness, osteoporosis, hypertension, and diabetes mellitus, among others.
## **Why Each Wrong Option is Incorrect**
- **Option A:** Typically, weight gain, particularly central obesity, is a feature of Cushing's syndrome, not weight loss.
- **Option B:** Hypertension is a common finding due to the effects of cortisol on blood pressure regulation.
- **Option C:** Glucose intolerance or diabetes mellitus can occur due to the diabetogenic effects of cortisol.
- **Option D:** Osteoporosis is a well-recognized complication, primarily due to the catabolic effects of excess cortisol on bone.
## **Why the Correct Answer is Right - Detailed Analysis for D**
Given that osteoporosis (Option D) is indeed a feature, and assuming **Option A** (not provided) suggests weight loss, this would stand out as not typical. Cushing's syndrome characteristically presents with weight gain.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that while Cushing's syndrome leads to muscle weakness, it characteristically causes proximal muscle weakness. A simple way to remember common features is to think of the "4 Ds": Diabetes, Depression, Dementia (or psychological changes), and Death (from complications if untreated).
## **Correct Answer: A. Weight loss.**