Which constellation of features is most consistent with Cushing syndrome due to ACTH excess?

Which constellation of features is most consistent with Cushing syndrome due to ACTH excess?

• A. Moonface, truncal obesity, hypertension, petechiae.
• B. Hypoglycemia, weight loss, hypotension.
• C. Hyperkalemia, hyponatremia.
• D. Polyuria, polydipsia.

Answer: (A)

Cushing syndrome from ACTH excess produces a clinical picture of chronic cortisol overload, with fat redistribution and fragile skin. Moon facies and truncal obesity reflect central fat deposition driven by cortisol. Hypertension occurs because cortisol in high amounts promotes sodium retention and increases vascular sensitivity to catecholamines. Petechiae come from skin thinning and capillary fragility due to collagen breakdown and impaired wound healing. This combination—rounded face, central obesity, high blood pressure, and easily bruising skin—is classic for ACTH‑dependent Cushing syndrome. The other options don’t fit this pattern: hypoglycemia with weight loss and low blood pressure suggests adrenal insufficiency; hyperkalemia with hyponatremia points toward primary adrenal failure; polyuria and polydipsia are more typical of diabetes or uncontrolled hyperglycemia, not the characteristic Cushingoid changes.

Cushing syndrome from ACTH excess produces a clinical picture of chronic cortisol overload, with fat redistribution and fragile skin. Moon facies and truncal obesity reflect central fat deposition driven by cortisol. Hypertension occurs because cortisol in high amounts promotes sodium retention and increases vascular sensitivity to catecholamines. Petechiae come from skin thinning and capillary fragility due to collagen breakdown and impaired wound healing. This combination—rounded face, central obesity, high blood pressure, and easily bruising skin—is classic for ACTH‑dependent Cushing syndrome.

The other options don’t fit this pattern: hypoglycemia with weight loss and low blood pressure suggests adrenal insufficiency; hyperkalemia with hyponatremia points toward primary adrenal failure; polyuria and polydipsia are more typical of diabetes or uncontrolled hyperglycemia, not the characteristic Cushingoid changes.