42-year-old Woman in Medicine / Internal Medicine — 42yo Woman | Endocrinology | SMLE Q#17810
SMLE Question #17810
Medicine / Internal Medicine
Endocrinology
Objective: OBJ-ADDISON-DOSE-1
Last updated: February 2026
A 42-year-old woman has 10 months of progressive truncal weight gain, new hypertension, proximal muscle weakness, easy bruising, irregular menses, facial rounding, supraclavicular fullness, wide violaceous abdominal striae, and ecchymoses. Screening confirms endogenous hypercortisolism. Morning plasma ACTH is elevated rather than suppressed. Based on the cortisol–ACTH pattern, what is the most likely cause of her Cushing syndrome?
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