A 39-year-old woman with Cushing disease presents for pituitary ACTH reserve testing. Vital signs show BP 148/92, HR 88, RR 14, Temp 37°C. She has central obesity and proximal muscle weakness but denies headaches. Baseline cortisol is 32 mcg/dL (elevated). A drug inhibiting 11β-hydroxylase is administered, causing cortisol to decrease and 11-deoxycortisol to increase substantially. She takes no prior medications. Which drug was most likely administered?

  1. A)Hydrocortisone
  2. B)MetyraponeGABARITO
  3. C)Fludrocortisone
  4. D)Ketoconazole
  5. E)Radioactive iodine

Explicação

Metyrapone inhibits 11 beta hydroxylase and lowers cortisol synthesis, causing accumulation of 11-deoxycortisol. It is used diagnostically and therapeutically in hypercortisolism, and androgen precursor buildup can produce hirsutism. Ver explicação completa e trilha adaptativa →

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