A 37-year-old woman comes to the physician because of irregular menses and generalized fatigue for the past 4 months. Menses previously occurred at regular 25- to 29-day intervals and lasted for 5 days but now occur at 45- to 60-day intervals. She had a prolonged history of systemic lupus erythematosus treated with multiple medications and was recently evaluated for progressive muscle weakness. She is 155 cm (5 ft 1 in) tall and weighs 89 kg (196 lb); BMI is 37 kg/m2. Her temperature is 37°C (98.6°F), pulse is 90/min, and blood pressure is 146/100 mm Hg. Physical examination shows excessive fat accumulation in the abdomen and supraclavicular area. Coarse hair is present on the face, chest, and abdomen. Examination of this patient's adrenal glands is most likely to reveal which of the following findings?

Question

A 37-year-old woman comes to the physician because of irregular menses and generalized fatigue for the past 4 months. Menses previously occurred at regular 25- to 29-day intervals and lasted for 5 days but now occur at 45- to 60-day intervals. She had a prolonged history of systemic lupus erythematosus treated with multiple medications and was recently evaluated for progressive muscle weakness. She is 155 cm (5 ft 1 in) tall and weighs 89 kg (196 lb); BMI is 37 kg/m2. Her temperature is 37°C (98.6°F), pulse is 90/min, and blood pressure is 146/100 mm Hg. Physical examination shows excessive fat accumulation in the abdomen and supraclavicular area.  Coarse hair is present on the face, chest, and abdomen. Examination of this patient's adrenal glands is most likely to reveal which of the following findings?

Quizplus · Accepted Answer

Eductional Objective: Long-term use of supraphysiologic doses of glucocorticoids causes suppression of the hypothalamic-pituitary-adrenal axis, which in turn leads to bilateral adrenocortical atrophy involving the zona fasciculata and reticularis.  Sudden cessation of the exogenous corticosteroids can precipitate adrenal crisis.

A 37-Year-Old Woman Comes to the Physician Because of Irregular