Endocrine Weight Loss Endocrine Pathology 2 — Questions and Answers
Question 1: A patient with Cushing's syndrome typically gains weight primarily in which distribution pattern?
- Peripheral (arms and legs)
- Central (truncal and visceral) (Correct answer)
- Generalized uniform distribution
- Lower body (hips and thighs)
Correct answer: Central (truncal and visceral)
Cushing's syndrome causes excess cortisol, which preferentially promotes central/visceral fat accumulation, buffalo hump, and moon face.
Question 2: Which thyroid condition is MOST commonly associated with significant unexplained weight gain?
- Hyperthyroidism
- Hypothyroidism (Correct answer)
- Thyroid cancer
- Subacute thyroiditis
Correct answer: Hypothyroidism
Hypothyroidism slows metabolism due to insufficient thyroid hormone, leading to weight gain, fatigue, and cold intolerance.
Question 3: A 45-year-old woman presents with weight gain, hypertension, and a serum cortisol that fails to suppress after an overnight low-dose dexamethasone test. The most likely diagnosis is:
- Primary hyperaldosteronism
- Cushing's syndrome (Correct answer)
- Pheochromocytoma
- Adrenal insufficiency
Correct answer: Cushing's syndrome
Failure to suppress cortisol after the low-dose dexamethasone suppression test is the hallmark finding of Cushing's syndrome.
Question 4: Polycystic ovary syndrome (PCOS) promotes weight gain primarily through which pathophysiological mechanism?
- Elevated estrogen causing fluid retention
- Insulin resistance promoting fat storage and increased appetite (Correct answer)
- Excess LH suppressing thyroid function
- Elevated FSH increasing cortisol levels
Correct answer: Insulin resistance promoting fat storage and increased appetite
PCOS is strongly linked to insulin resistance, which drives hyperinsulinemia, fat deposition (especially visceral), and increased appetite.
Question 5: Which hormone produced by adipose tissue signals satiety to the hypothalamus and is often deficient or resistant in obesity?
- Ghrelin
- Adiponectin
- Leptin (Correct answer)
- Resistin
Correct answer: Leptin
Leptin is produced by fat cells and signals fullness to the hypothalamus; obese individuals often develop leptin resistance despite high levels.
Question 6: A patient with type 2 diabetes and obesity has elevated fasting insulin levels. This finding most directly indicates:
- Pancreatic beta-cell destruction
- Insulin resistance requiring compensatory hypersecretion (Correct answer)
- Growth hormone excess
- Adrenal cortisol overproduction
Correct answer: Insulin resistance requiring compensatory hypersecretion
High fasting insulin in a hyperglycemic patient reflects compensatory pancreatic hypersecretion due to peripheral insulin resistance.
Question 7: Growth hormone deficiency in adults most commonly leads to which body composition change?
- Increased lean muscle mass with stable fat
- Increased visceral fat and decreased lean mass (Correct answer)
- Decreased total body fat with muscle atrophy
- Increased subcutaneous fat only
Correct answer: Increased visceral fat and decreased lean mass
Adult GH deficiency reduces lipolysis and muscle maintenance, resulting in increased visceral adiposity and reduced lean body mass.
Endocrine Weight Loss Endocrine Pathology 2
A patient with Cushing's syndrome typically gains weight primarily in which distribution pattern?