doc179
Forum Guru
Topics: 67
Posts: 1,217
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A 48-year-old woman has experienced constant back pain exacerbated by movement over the past month. She reports increasing weakness over the past 3 months. On physical examination her blood pressure of 165/110 mm Hg. She is mildly obese with a BMI of 28. A radiograph of the spine reveals a compressed fracture at T10. Laboratory findings include a serum glucose of 155 mg/dL. Which of the following pathologic lesions is most likely to explain her findings?
A Adrenal cortical carcinoma
B Anaplastic thyroid carcinoma
C Empty sella syndrome
D Pheochromocytoma
E Multinodular goiter
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| po
Forum Elite
Topics: 39
Posts: 356
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HYPERTENSION,OSTEOPOROSIS[?],WEAKNESS[HYPOKALEMIA[?],OBESITY[CENTRAL],HYPER GLYCEMIA
all point to A
could be right.
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| new_n_lost
Politically InCorrect
Topics: 653
Posts: 6,085
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Adrenal cortical carcinoma 
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| doc179
Forum Guru
Topics: 67
Posts: 1,217
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(A) CORRECT. She has Cushing syndrome with osteoporosis, hypertension, obesity, and diabetes mellitus. Many adrenal cortical carcinomas function and can produce excess cortisol
(B) Incorrect. Thyroid carcinomas do not explain the finding of diabetes mellitus, though the fracture could have been from a metastasis.
(C) Incorrect. Hypopituitarism could result from the empty sella syndrome, but this would not explain hypertension, osteoporosis, and diabetes mellitus.
(D) Incorrect. A pheochromocytoma of the adrenal medulla or extra-adrenal paraganglion system secretes norepinephrine or epinephrine that could account for hypertension, but not diabetes mellitus nor osteoporosis.
(E) Incorrect. Goiters are not associated with osteoporosis or diabetes mellitus.
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