Endocrine Pharmacology USMLE Step 1 Practice Question
A 37-year-old man with small cell lung carcinoma presents with ectopic ACTH syndrome. Vital signs show BP 168/98 mmHg, HR 102, RR 18, temp 37.2°C. Physical examination reveals central obesity, proximal muscle weakness, and hyperpigmentation. Labs reveal 24-hour urine cortisol 450 mcg (normal <50), morning cortisol 38 mcg/dL, and serum potassium 2.9 mEq/L. He denies recent infections. While awaiting chemotherapy, he is started on a medication dosed at 400 mg daily that inhibits adrenal steroid synthesis but carries risks of hepatotoxicity and gynecomastia. Which drug was prescribed?
Answer choices
- AHydrocortisone
- BMetyrapone
- CKetoconazoleCorrect answer
- DFludrocortisone
- EDexamethasone
- FMitotane
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