The most likely diagnosis for a lady with central obesity showing purple striae on abdominal skin is:
**Core Concept**
The question tests the ability to diagnose **Cushing's syndrome**, a disorder caused by excess **cortisol** levels. Central obesity and purple striae are key clinical features.
**Why the Correct Answer is Right**
Cushing's syndrome results from prolonged exposure to high cortisol levels, often due to **adenomas** in the **pituitary gland** or **adrenal glands**. This leads to **lipid redistribution**, causing central obesity, and **skin thinning**, resulting in purple striae.
**Why Each Wrong Option is Incorrect**
**Option A:** Not directly related to the symptoms described.
**Option B:** May cause obesity but not typically purple striae.
**Option C:** Can cause weight gain but the pattern and associated symptoms differ.
**Clinical Pearl / High-Yield Fact**
Remember, **Cushing's syndrome** often presents with a combination of central obesity, **hypertension**, **hyperglycemia**, and specific skin changes like purple striae.
**Correct Answer:** D. Cushing's syndrome.