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Please provide citations when answering the following case studies. At least 2 r
Please provide citations when answering the following case studies. At least 2 references are present (text, outside scholarly source less than 5 years old). See the attached rubric
A 35-year-old woman has recent onset hypertension. The review of systems reveals several months of weight gain and menstrual irregularity. On examination, she is obese, with a plethoric appearance. The blood pressure is 165/98 mm Hg. There are prominent purplish striae over the abdomen and multiple bruises over both lower legs. She is diagnosed with hypercortisolism (Cushing syndrome).
1. What other history and physical examination features should be sought?
2. Assuming that the diagnosis of hypercortisolism is correct, what is the underlying pathogenesis of this patient’s hypertension, weight gain, and skin striae?
3. List four causes of Cushing syndrome, and discuss the relationships among the hypothalamus, pituitary, and adrenal in each. Which is the most likely cause in this patient?
4. How can the diagnosis of hypercortisolism be established in this patient?
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