A 42-year-old woman reports excessive weight gain in the abdomen and shoulders, excessive hair growth on her face, and an intermittent menses. The reported signs are associated with ______.

A 42-year-old woman reports excessive weight gain in the abdomen and shoulders, excessive hair growth on her face, and an intermittent menses. The reported signs are associated with ______.

• A. Diabetes insipidus
• B. Cushing syndrome
• C. Addison disease
• D. gigantism

Answer: (B)

Excess cortisol effects create this pattern. When cortisol is chronically elevated, fat is redistributed to the trunk and upper body, producing central obesity with fat pad buildup on the abdomen and upper back (often described as a buffalo hump) and a rounded or moon-like face. Cortisol can also enhance androgen activity or production, leading to unwanted facial hair growth (hirsutism) and irregular or skipped menses. This combination is typical for Cushing syndrome, where the problem is too much glucocorticoid exposure from endogenous sources (like pituitary ACTH overproduction or adrenal tumors) or from external steroid use. The other conditions don’t fit this picture: diabetes insipidus presents with polyuria and polydipsia without purposeful fat redistribution or hirsutism; Addison disease typically causes weight loss, fatigue, hypotension, and hyperpigmentation rather than central obesity and hair growth; gigantism involves excessive growth hormone leading to tall stature rather than the described body fat distribution and menstrual changes.

Excess cortisol effects create this pattern. When cortisol is chronically elevated, fat is redistributed to the trunk and upper body, producing central obesity with fat pad buildup on the abdomen and upper back (often described as a buffalo hump) and a rounded or moon-like face. Cortisol can also enhance androgen activity or production, leading to unwanted facial hair growth (hirsutism) and irregular or skipped menses. This combination is typical for Cushing syndrome, where the problem is too much glucocorticoid exposure from endogenous sources (like pituitary ACTH overproduction or adrenal tumors) or from external steroid use.

The other conditions don’t fit this picture: diabetes insipidus presents with polyuria and polydipsia without purposeful fat redistribution or hirsutism; Addison disease typically causes weight loss, fatigue, hypotension, and hyperpigmentation rather than central obesity and hair growth; gigantism involves excessive growth hormone leading to tall stature rather than the described body fat distribution and menstrual changes.