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

What condition does prolonged exposure to high levels of cortisol typically result in?

1. Addison's disease

2. Cushing's syndrome

3. Hypopituitarism

4. Conn's syndrome

The correct answer is: Cushing's syndrome

Prolonged exposure to high levels of cortisol results in Cushing's syndrome. This condition is characterized by symptoms such as weight gain, particularly in the abdominal area, a rounded face, and easy bruising, among others. The excess cortisol can be due to various factors such as a pituitary adenoma (which increases adrenocorticotropic hormone, or ACTH production), adrenal tumors, or ectopic ACTH secretion from tumors elsewhere in the body. Cushing's syndrome reflects the clinical manifestations of excess glucocorticoids, resulting in metabolic, psychological, and immune system changes. In contrast, Addison's disease involves insufficient cortisol production, resulting from damage to the adrenal glands. Hypopituitarism is a condition in which the pituitary gland does not produce sufficient hormones, which can lead to secondary adrenal insufficiency but is not characterized by high cortisol levels. Conn's syndrome primarily involves excess production of aldosterone, leading to hypertension and electrolyte imbalance, not elevated cortisol. Thus, Cushing's syndrome is the appropriate answer when considering prolonged cortisol exposure.