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Question

A tumor was detected in the adrenal cortex of a person. He was found to have high blood glucose. Glucose was detected in his urine samples too. In addition the doctor observed purple streaks on the abdominal wall. Which disease is he most likely suffering from?

A
Cushing's syndrome
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B
Adrenal virilism
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C
Aldosteronism
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D
Cretinism
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Solution

The correct option is A Cushing's syndrome
Cushing's syndrome is due to excess of cortisol, a hormone secreted by the adrenal cortex. Often tumours of the adrenal cortex result in overproduction of this hormone. Cortisol is the prinicipal glucocorticoid secreted from the adrenal cortex and functions in glucose metabolism.

Due to excess cortisol, patients have elevated blood sugars, to the point where it spills over into urine. There is a resultant obesity, characteristically seen in the abdominal region, with very thin limbs often due to wasting of muscle. Fat also accumulates in the upper back, giving the sufferer a hunchback. Sodium levels in plasma rise and potassium levels fall. This is followed by massive water retention leading to puffiness in the face and an obvious concurrent increase in blood volume levels. Increased blood volume levels result in hypertension. In addition, purple streaks are often seen on the abdominal wall.

Cretinism is due to hyposecretion of the thyroid hormone in infants and children. Adrenal virilism is due to excess of androgens in females and aldosteronism is a result of excessive aldosterone.

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