The Question is from neet-zoology chemical-coordincation-and-integration , and it was created by the author Mr. BALACHANDRA.N

Question

A patient presents with persistent hyperglycemia, muscle weakness, and central obesity.  Upon examination, they are found to have elevated cortisol levels.  Which of the following is the LEAST likely cause of these symptoms?

Mr. BALACHANDRA.N · Accepted Answer

## CORE INFORMATION
✓ **Answer**: D
## CONCEPT FRAMEWORK
 **Primary Concept**: Cushing's Syndrome and its causes
 **Related Topics**: Endocrine system, adrenal gland function, pituitary gland function, hormone imbalances
 **Prerequisites**: Understanding of the hypothalamic-pituitary-adrenal (HPA) axis, the role of cortisol, and the symptoms of hypercortisolism.
## SOLUTION PATHWAY
**Given Information**:
  Persistent hyperglycemia, muscle weakness, central obesity, elevated cortisol levels.
  These symptoms are highly suggestive of Cushing's syndrome, a condition characterized by excessive cortisol in the body.
**Method & Steps**:
 1. Identify the potential causes of Cushing's syndrome.
  Reasoning: Cushing's syndrome can be caused by problems within the HPA axis, exogenous administration of glucocorticoids, or tumors.
 2. Analyze each option to determine the likelihood of causing the presented symptoms.
  Working: 
  A. Pituitary adenoma secreting ACTH:  ACTH (adrenocorticotropic hormone) stimulates cortisol production. A pituitary adenoma can lead to excessive ACTH secretion, resulting in high cortisol levels and Cushing's symptoms.
  B. Adrenal cortex tumor secreting cortisol:  An adrenal tumor can autonomously produce cortisol, leading to Cushing's syndrome, bypassing the normal HPA axis regulation.
  C. Exogenous administration of glucocorticoids:  Taking high doses of glucocorticoid medications (like prednisone) can also cause Cushing's syndrome.
  D. Adrenal medulla tumor secreting epinephrine:  The adrenal medulla secretes catecholamines (epinephrine and norepinephrine), not cortisol.  A tumor here would primarily cause symptoms related to excess catecholamines (e.g., hypertension, tachycardia), not the symptoms of Cushing's syndrome.
 3. Determine the least likely cause.
  Result: Option D is the least likely cause because an adrenal medulla tumor secreting epinephrine doesn't directly cause hypercortisolism.
  Verification: The symptoms described strongly align with hypercortisolism, and options A, B, and C are all known causes.  Option D is unrelated to cortisol production.
 ## OPTION ANALYSIS
A ✓:  A pituitary adenoma secreting ACTH is a common cause of Cushing's syndrome.
B :x: An adrenal cortex tumor secreting cortisol is a direct cause of Cushing's syndrome.
C :x: Exogenous glucocorticoid administration is a known cause of Cushing's syndrome.
D :x: An adrenal medulla tumor secreting epinephrine is not a cause of Cushing's syndrome; it would lead to a different set of symptoms.
 ## LEARNING AIDS
 **Common Mistakes**:
  1.Confusing the adrenal cortex and medulla:  Remember the cortex produces cortisol, while the medulla produces catecholamines.
  2.Overlooking exogenous causes:  Be aware that medication can mimic endocrine disorders.
 **Quick Tips**:
  1.Remember the key symptoms of Cushing's syndrome (hyperglycemia, central obesity, muscle weakness) to quickly identify the condition.
  2.Use a mnemonic device to remember the locations of hormone production within the adrenal gland (e.g., Cortex = Cortisol).

Mr. BALACHANDRA.N · Answer

Pituitary adenoma secreting ACTH

Mr. BALACHANDRA.N · Answer

Adrenal cortex tumor secreting cortisol

Mr. BALACHANDRA.N · Answer

Exogenous administration of glucocorticoids

Mr. BALACHANDRA.N · Answer

The correct Option is "Adrenal medulla tumor secreting epinephrine"

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