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Repeated USMLE Questions Step 2 CK - anther0
#1
A 32 year-old man complains of fatigue, weakness, edema and acne for 6 months. He is 70-In tall and weighs 220 Ib. His blood pressure is 148/90 mmHg. He has central obesity, enlarged subclavicular fat pads and prominent abdominal striae. His lab tests are:
24-hour urine cortisol excretion is 288
Serum cortisol level is 18 at 8:00 am after taking 1 mg of dexamethasone at bedtime and next day it was 18.9 after at 8:00 am after taking 8 mg of dexamethasone at bedtime.
Plasma ACTH level is 281
What is the most likely site of the disorder causing Cushing syndrome in this patient?
A- Pituitary gland
B- Hypothalamus
C- Lungs
D- Adrenal glands
E- Pancreas
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#2
ACTH is HIGH with no supression in high or low Dexa so ECTOPIC. MC site for ectopic Lungs.

Let us know the coreect answer. Thanks for the post
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#3
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