A 58-year-old woman with severe rheumatoid arthritis treated with daily oral glucocorticoids for 9 months presents with proximal muscle weakness, thin skin, easy bruising, and hyperglycemia (fasting glucose 165 mg/dL). Physical examination reveals hypertension (BP 158/94 mmHg) and central obesity. DEXA scan demonstrates vertebral compression fractures with T-score of -3.2. She denies fever or recent infections. Which medication is most likely responsible for these findings?

  1. A)Cinacalcet
  2. B)HydrocortisoneGABARITO
  3. C)Finasteride
  4. D)Levothyroxine
  5. E)Clomiphene

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 →

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