32-year-old Woman in Medicine / Internal Medicine — 32yo Woman | Endocrinology | SMLE Q#11635
SMLE Question #11635
Medicine / Internal Medicine
Endocrinology
Objective: OBJ-ADDISON-DOSE-1
Last updated: February 2026
A 32-year-old woman has 1 year of progressive weight gain, proximal muscle weakness, easy bruising, irregular menses, and new hirsutism. Examination shows central obesity, facial rounding, and a dorsocervical fat pad. She denies using prescribed, inhaled, topical, or herbal glucocorticoids. Screening confirms hypercortisolism, and plasma ACTH is elevated. Which of the following is the most likely underlying cause of her condition?
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