A 45-Year-Old Woman Is Being Examined by Her Physician Because

A 45-year-old woman is being examined by her physician because she is concerned about her weight gain, fatigue, muscle weakness, and thinning hair. Physical examination shows a "buffalo hump," facial hirsutism, and red striae in abdominal and underarm areas. She indicates that she is not on any medication and there is no significant past history or family history. Laboratory studies show an elevated fasting blood glucose (11 mmol/L: 198 mg/dL) and a 24-hour urinary cortisol of 2276 nmol/24 h. These signs and symptoms are most likely the result of which of the following?

A) Addison disease
B) Cushing syndrome
C) Graves disease
D) hyperthyroidism
E) pituitary adenoma