A patient with newly diagnosed hypertension, rapid weight gain, and easy bruising is most likely to have which condition?

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Multiple Choice

A patient with newly diagnosed hypertension, rapid weight gain, and easy bruising is most likely to have which condition?

Excess cortisol is the key idea here. When cortisol levels are high, the body tends to gain weight in the trunk, retain salt and water (raising blood pressure), and have fragile skin that bruises easily because collagen synthesis is impaired. This combination of high blood pressure, rapid weight gain, and easy bruising points to hypercortisolism, i.e., Cushing syndrome. Cushing disease is a pituitary-driven cause of this syndrome, with excess ACTH prompting the adrenal glands to make more cortisol, producing these features. Other conditions don’t fit this pattern as well. Graves’ disease causes hyperthyroid symptoms such as weight loss, heat intolerance, and tremor, not the fat redistribution with bruising seen here. Diabetes mellitus can involve weight changes and poor wound healing, but the classic trio of hypertension with rapid weight gain and easy bruising is more characteristic of excess cortisol. Myxedema coma is a severe hypothyroid emergency—with hypothermia, mental status changes, and edema—rather than the cortisol-driven changes described.

Excess cortisol is the key idea here. When cortisol levels are high, the body tends to gain weight in the trunk, retain salt and water (raising blood pressure), and have fragile skin that bruises easily because collagen synthesis is impaired. This combination of high blood pressure, rapid weight gain, and easy bruising points to hypercortisolism, i.e., Cushing syndrome. Cushing disease is a pituitary-driven cause of this syndrome, with excess ACTH prompting the adrenal glands to make more cortisol, producing these features.

Other conditions don’t fit this pattern as well. Graves’ disease causes hyperthyroid symptoms such as weight loss, heat intolerance, and tremor, not the fat redistribution with bruising seen here. Diabetes mellitus can involve weight changes and poor wound healing, but the classic trio of hypertension with rapid weight gain and easy bruising is more characteristic of excess cortisol. Myxedema coma is a severe hypothyroid emergency—with hypothermia, mental status changes, and edema—rather than the cortisol-driven changes described.

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