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Multiple Choice

Which of the following are common features of Cushing syndrome?

Excess glucocorticoids produce the characteristic appearance and physiology of Cushing syndrome. Hypertension arises because cortisol enhances vascular reactivity and promotes sodium and water retention. Central (centripetal) obesity and moon facies reflect fat redistribution under high cortisol levels, while purple striae result from thinning of skin and connective tissue. The test finding of cortisol not being suppressed by dexamethasone points to endogenous hypercortisolism—normal individuals and those only exposed to external steroids would typically show some suppression with dexamethasone. The other options describe patterns that are not typical of cortisol excess (such as symptoms seen in adrenal insufficiency or misaligned electrolyte disturbances), so the combination of hypertension, central obesity with moon facies and purple striae, and lack of dexamethasone suppression best fits Cushing syndrome.

Excess glucocorticoids produce the characteristic appearance and physiology of Cushing syndrome. Hypertension arises because cortisol enhances vascular reactivity and promotes sodium and water retention. Central (centripetal) obesity and moon facies reflect fat redistribution under high cortisol levels, while purple striae result from thinning of skin and connective tissue. The test finding of cortisol not being suppressed by dexamethasone points to endogenous hypercortisolism—normal individuals and those only exposed to external steroids would typically show some suppression with dexamethasone. The other options describe patterns that are not typical of cortisol excess (such as symptoms seen in adrenal insufficiency or misaligned electrolyte disturbances), so the combination of hypertension, central obesity with moon facies and purple striae, and lack of dexamethasone suppression best fits Cushing syndrome.