A 25-year-old lady has put on weight and has oligomenorrhea followed by amenorrhea for 8 months. The blood pressure is 160/100 mm of Hg. Which of the following is the most appropriate investigation?
Serum electrolytes
Plasma cortisol
Plasma testosterone and USG
T3, T4 and TSH
Ans. B. Plasma cortisolThe given clinical situation suggests a diagnosis of Cushing's which is diagnosed by Cortisol levels.* Weight gain with oligomenorrhea points to Cushing's syndrome.* Cortisol inhibits gonadotropin release that explains amenorrhea.* Hypertension in these patients is secondary to increased cortisol that has some mineralocorticoid activity also.
Endocrinology