A 50-year-old male patient presents with facial rounding, central obesity, and purple striae on the abdomen. Laboratory results show high levels of ACTH. What is the most likely underlying cause of his condition?
Adrenal insufficiency.
Pheochromocytoma.
Cushing Disease.
Hyperthyroidism.
The Correct Answer is C
Choice A Reason:
Adrenal insufficiency, also known as Addison’s disease, is characterized by insufficient production of cortisol and aldosterone by the adrenal glands. Symptoms typically include fatigue, weight loss, low blood pressure, and hyperpigmentation of the skin. High levels of ACTH are not associated with adrenal insufficiency; instead, ACTH levels are usually elevated in response to low cortisol levels.
Choice B Reason:
Pheochromocytoma is a rare tumor of the adrenal gland that produces excess catecholamines, leading to symptoms such as hypertension, palpitations, and headaches. It does not cause high levels of ACTH or the physical manifestations described in the patient, such as facial rounding and purple striae.
Choice C Reason:
Cushing Disease is caused by a pituitary adenoma that secretes excess adrenocorticotropic hormone (ACTH), leading to overproduction of cortisol by the adrenal glands. This results in symptoms such as facial rounding (moon face), central obesity, purple striae on the abdomen, and high levels of ACTH. These clinical features align with the patient’s presentation, making Cushing Disease the most likely underlying cause.
Choice D Reason:
Hyperthyroidism is characterized by excessive production of thyroid hormones, leading to symptoms such as weight loss, heat intolerance, palpitations, and tremors. It does not cause high levels of ACTH or the specific physical changes seen in Cushing Disease.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Methimazole is an antithyroid medication that inhibits the synthesis of thyroid hormones. It is commonly used to manage hyperthyroidism, especially in patients who are not candidates for radioactive iodine therapy or surgery. Methimazole is effective in reducing thyroid hormone levels and controlling symptoms, but it requires long-term use and regular monitoring of thyroid function tests.
Choice B Reason:
Levothyroxine is a synthetic form of thyroxine (T4) used to treat hypothyroidism, not hyperthyroidism. Administering levothyroxine to a patient with hyperthyroidism would exacerbate the condition by increasing thyroid hormone levels. Therefore, it is not an appropriate treatment for managing hyperthyroidism.
Choice C Reason:
Radioactive iodine is a widely used treatment for hyperthyroidism. It works by destroying overactive thyroid cells, thereby reducing the production of thyroid hormones. This treatment is particularly effective for patients with Graves’ disease, toxic multinodular goiter, or toxic adenoma. Radioactive iodine is a definitive treatment that can lead to a permanent resolution of hyperthyroidism, although it may result in hypothyroidism, which can be managed with levothyroxine.
Choice D Reason:
Propranolol is a beta-blocker that helps manage the symptoms of hyperthyroidism, such as palpitations, tremors, and anxiety. While it is useful for symptomatic relief, it does not address the underlying cause of hyperthyroidism. Propranolol is often used in conjunction with other treatments, such as antithyroid medications or radioactive iodine, to provide immediate symptom control.
Correct Answer is B
Explanation
Choice A Reason:
Increased appetite is not typically associated with anemia. Anemia generally leads to symptoms related to decreased oxygen-carrying capacity of the blood, such as fatigue, weakness, and shortness of breath. Increased appetite is more commonly linked to other conditions, such as hyperthyroidism or certain metabolic disorders.
Choice B Reason:
Fatigue is a common and significant symptom of anemia. When hemoglobin levels are low, the body’s tissues do not receive adequate oxygen, leading to feelings of tiredness and exhaustion. This is because hemoglobin is responsible for transporting oxygen from the lungs to the rest of the body. In anemia, the reduced oxygen delivery results in decreased energy levels and persistent fatigue.
Choice C Reason:
Weight gain is not typically associated with anemia. In fact, some forms of anemia, such as those caused by chronic diseases or malnutrition, may lead to weight loss rather than gain. Weight gain can be associated with other health issues, such as hypothyroidism or fluid retention, but not directly with anemia.
Choice D Reason:
Hypertension is not a common manifestation of anemia. Anemia usually leads to symptoms like pallor, shortness of breath, and fatigue due to the reduced oxygen-carrying capacity of the blood. Hypertension, or high blood pressure, is more commonly associated with cardiovascular diseases, kidney disorders, or endocrine conditions.
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