A 58-year-old woman with rheumatoid arthritis treated with daily oral glucocorticoids for 9 months presents with proximal muscle weakness, thin fragile skin, and easy bruising. Vital signs show BP 158/92 mmHg, HR 88/min, RR 16/min, temp 37°C. Laboratory studies reveal fasting glucose 186 mg/dL and serum potassium 3.2 mEq/L. Imaging demonstrates acute vertebral compression fractures. She denies recent infections. Which medication is most likely responsible for these findings?
- A)Cinacalcet
- B)Finasteride
- C)Levothyroxine
- D)Clomiphene
- E)HydrocortisoneGABARITO
Explicação
Chronic glucocorticoid exposure causes iatrogenic Cushing syndrome with muscle wasting, skin fragility, hyperglycemia, and osteoporosis. Hydrocortisone is a glucocorticoid and can produce exactly this toxicity pattern when used long term. Ver explicação completa e trilha adaptativa →