American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which syndrome is known as hypercortisolism resulting from prolonged exposure to high cortisol levels?

1. Addison's disease

2. Cushing's syndrome

3. Primary adrenal insufficiency

4. Conn's syndrome

The correct answer is: Cushing's syndrome

Hypercortisolism, characterized by prolonged exposure to elevated cortisol levels in the body, is known as Cushing's syndrome. This condition can result from various factors, including endogenous overproduction of cortisol, often due to adrenal tumors or pituitary adenomas that stimulate cortisol secretion, or from exogenous sources such as prolonged use of corticosteroid medications. Cushing's syndrome manifests with a variety of symptoms, including weight gain, particularly in the abdominal area, facial rounding, easy bruising, and other metabolic derangements like insulin resistance. The diagnosis is typically confirmed through biochemical tests that assess cortisol levels, such as 24-hour urinary free cortisol tests or late-night salivary cortisol tests. Other conditions mentioned, such as Addison's disease and primary adrenal insufficiency, involve insufficient cortisol production rather than excess, leading to different clinical features and implications. Conn's syndrome specifically relates to an overproduction of aldosterone rather than cortisol, thus does not pertain to hypercortisolism.