Endocrine Pharmacology USMLE Step 1 Practice Question
A 45-year-old woman with central obesity, proximal muscle weakness, and easy bruising undergoes evaluation for Cushing syndrome. Vital signs show BP 158/92 mmHg, HR 88 bpm, RR 16/min, temp 37.2°C. Laboratory studies reveal 24-hour urinary free cortisol 250 mcg (normal <50), with morning ACTH 35 pg/mL. An exogenous glucocorticoid is administered overnight, and serum cortisol is measured the following morning to assess suppression of ACTH-driven endogenous cortisol production. Which drug is most appropriate for this diagnostic test?
Answer choices
- AKetoconazole
- BDexamethasoneCorrect answer
- CHydrocortisone
- DMifepristone
- EFludrocortisone
- FSpironolactone
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