Surrenal

Which of the following symptoms are seen in hypercortisolism (Cushing's syndrome)?
A. Thickening of the dermis
B. Psychotic disorders
C. Facio-truncular obesity
D. Purple and thin striae (stretch marks)
E. Muscle wasting (amyotrophy)

B, C, D, E. Hypercortisolism causes skin thinning (atrophy), not thickening, along with "buffalo hump" and "moon face" fat distribution.

Acute adrenal insufficiency can also manifest as:
A. Arterial hypertension
B. Arterial hypotension
C. Diarrhea
D. Constipation
E. Hypoglycemia

B, C, E. Acute adrenal crisis is a medical emergency characterized by vascular collapse (hypotension) and severe digestive disturbances.

Which of the following signs are observed in acute adrenal insufficiency?
A. Hypoglycemia
B. Hypokalemia
C. Arterial hypotension
D. Abdominal pain
E. Diarrhea

A, C, D, E. Adrenal crisis typically causes hyperkalemia (high potassium) due to mineralocorticoid deficiency, not hypokalemia.

Primary adrenal insufficiency or Addison's disease can manifest clinically as:
A. Global asthenia (exhaustion)
B. Cutaneous hypopigmentation
C. Slate-colored patches on mucous membranes
D. Weight loss
E. Arthralgia and myalgia

A, C, D, E. Addison's disease causes hyperpigmentation (melanoderma), particularly in the mouth (slate-colored spots) and skin creases.

Chronic (slow) adrenal insufficiency can manifest as:
A. Global asthenia that worsens at the end of the day
B. Weight loss
C. Weight gain
D. Cutaneous hyperpigmentation
E. Vomiting

A, B, D, E. Fatigue in adrenal insufficiency is characteristically "vesperal," meaning it increases as the day progresses.

Chronic adrenal insufficiency of peripheral origin manifests as:
A. Asthenia
B. Weight gain
C. Weight loss
D. Moderate arterial hypotension
E. Melanoderma (hyperpigmentation)

A, C, D, E. Peripheral origin (Addison's) involves high ACTH levels which stimulate melanin production, leading to skin darkening.

Characteristic skin hyperpigmentation in peripheral adrenal insufficiency should be sought in:
A. Friction zones (pressure points)
B. Normally pigmented regions
C. Extension zones
D. Sun-exposed areas
E. Scars

A, B, D, E. Hyperpigmentation is most visible on the palms, knuckles, inside the mouth, and on old scars.

Which of the following signs are observed in chronic adrenal insufficiency?
A. Weight gain
B. Physical, psychic, and sexual asthenia
C. Inconstant weight loss
D. Manifest arterial hypotension, especially in orthostasis (standing)
E. Amenorrhea

B, D, E. Weight loss is actually almost constant

The biological workup for suspected chronic adrenal insufficiency may show:
A. Low 8:00 AM serum cortisol
B. High 8:00 AM serum cortisol
C. High midnight serum cortisol
D. Absence of cortisol increase after a stimulation test (Synacthen)
E. None of the answers are correct

A, D. A low morning cortisol and a flat response to ACTH stimulation (Synacthen test) are diagnostic hallmarks.