امرأة عمرها ٤٤ سنة عندها وجه مستدير، وتجمع دهون بين الكتفين وفي البطن، وعلامات تمدد بنفسجية عريضة، وكدمات سهلة، وضغط مرتفع وسكر مرتفع. لا تأخذ كورتيزون. ما الحالة الأرجح؟

A 44-year-old woman has a round face, fat between the shoulders and abdomen, wide purple striae, easy bruising, hypertension and hyperglycaemia. She takes no steroids. What is most likely?

1. Hypothyroidism
2. Polycystic ovaries alone
3. Cushing’s syndrome
4. Addison’s disease

Answer: C) Cushing’s syndrome. Excess cortisol causes a moon face, buffalo hump, central obesity, purple striae, weakness, hypertension, hyperglycaemia and osteoporosis. Without exogenous steroids, a pituitary or adrenal source is sought.