Elevated Acth in Medicine / Internal Medicine — 34yo Woman | Endocrinology | SMLE Q#18788
SMLE Question #18788
Medicine / Internal Medicine
Endocrinology
Objective: OBJ-ENDO-CUSH-01
Last updated: March 2026
A 34-year-old woman has 8 months of progressive weight gain, facial rounding, proximal muscle weakness, and easy bruising. Examination shows central obesity and wide violaceous abdominal striae. She has persistent hypertension and denies prescribed or over-the-counter glucocorticoid use. Initial testing shows hypercortisolism with elevated ACTH. Which of the following is the most likely cause of her Cushing syndrome?
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