**Question:** Features of Cushing's syndrome are except-

A. Weight loss
B. Increased appetite
C. Elevated blood pressure
D. Altered mental status

**Core Concept:** Cushing's syndrome is a hormonal disorder caused by prolonged exposure to high levels of cortisol due to adrenal gland dysfunction or external corticosteroid administration. The syndrome is characterized by a range of symptoms and complications.

**Why the Correct Answer is Right:**
Cushing's syndrome is typically characterized by weight gain, easy bruising, fatty deposits on the face and upper back, muscle weakness, and a thin, wasting appearance. Weight loss (option A) is not a typical feature of Cushing's syndrome. Weight loss is more commonly seen in conditions like uncontrolled diabetes, anorexia nervosa, or certain malignancies.

**Why Each Wrong Option is Incorrect:**

A. Increased appetite: Although some cases of Cushing's syndrome may cause increased appetite, it is not a universal feature. Other symptoms often dominate, making weight loss a more prominent feature in some individuals.

B. Elevated blood pressure: Although hypertension is seen in some cases of Cushing's syndrome, it is not a defining feature. Weight gain and other symptoms are more indicative of the condition.

C. Altered mental status: Mood changes, depression, or irritability may occur in some cases of Cushing's syndrome. However, these changes are not specific to Cushing's syndrome and can be seen in other conditions as well.

**Clinical Pearl:**

Cushing's syndrome can be challenging to diagnose due to the overlapping symptoms with other conditions. A thorough clinical assessment, including physical examination, biochemical tests, and imaging studies, is essential to confirm the diagnosis.

**Correct Answer:** C. Elevated blood pressure (hypertension) is an option that can be present in some cases of Cushing's syndrome, but it is not the most characteristic feature of the condition. It is essential to focus on other symptoms such as weight gain, easy bruising, and the characteristic "moon face" when assessing a patient for Cushing's syndrome.