Which of the following is not seen in Cushing syndrome
**Core Concept**
Cushing syndrome is a hormonal disorder caused by prolonged exposure to high levels of cortisol, often due to an excess of adrenocorticotropic hormone (ACTH) or a cortisol-producing tumor. The excess cortisol disrupts the body's normal physiological processes, leading to various symptoms and complications.
**Why the Correct Answer is Right**
Cushing syndrome is characterized by a range of clinical features, including moon facies, buffalo hump, purple striae, hypertension, glucose intolerance, and osteoporosis. The correct answer will not be one of these typical manifestations.
**Why Each Wrong Option is Incorrect**
**Option A:** Weight loss - Cushing syndrome is typically associated with weight gain, particularly in the trunk and face, so weight loss is an unlikely feature.
**Option B:** Hypokalemia - While electrolyte imbalances can occur in Cushing syndrome, hypokalemia is more commonly seen in conditions like primary aldosteronism or Bartter syndrome.
**Option C:** Hypertrichosis - This is a common feature of Cushing syndrome, particularly in women, due to the excess cortisol's effect on hair growth.
**Option D:** Polyuria - While polyuria can occur in Cushing syndrome due to the effects of cortisol on the kidneys, it is not as distinctive a feature as some of the other options.
**Clinical Pearl / High-Yield Fact**
Remember that Cushing syndrome can be caused by both endogenous (e.g., ACTH-producing pituitary tumors) and exogenous (e.g., glucocorticoid medication) sources of cortisol excess. The clinical presentation and diagnostic approach may differ depending on the underlying cause.
**Correct Answer: A. Weight loss**