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ACTH-dependent Cushing syndrome — RACP Written MCQ

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HardEndocrinologyACTH-dependent Cushing syndromeRACP Written

A 35-year-old woman has weight gain, proximal weakness and new hypertension. Examination shows wide purple abdominal striae and bruising. Overnight dexamethasone suppression test fails to suppress cortisol. ACTH is elevated. What is the most appropriate investigation?

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Correct answer: A — Pituitary MRI after biochemical confirmation

ACTH-dependent Cushing syndrome should be localised after biochemical confirmation; pituitary MRI is a key next investigation.

Reference: Therapeutic Guidelines: Endocrinology; AMH