Gynaecological endocrinology: screening for Cushing syndrome: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological endocrinology: screening for Cushing syndrome

Sample item

A woman with hirsutism, central obesity, purple striae, hypertension and proximal weakness needs screening for Cushing syndrome. Which test is suitable?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. 1 mg overnight dexamethasone suppression test

A morning cortisol above the cut-off after 1 mg of dexamethasone at night fails to suppress and suggests cortisol excess. Late-night salivary cortisol or 24-hour urinary free cortisol are alternatives.

Option by option

  • A. Insulin tolerance test

    Insulin tolerance testing assesses cortisol and GH reserve in hypopituitarism.

  • B. 1 mg overnight dexamethasone suppression test (correct)

    Correct. Failure of cortisol to suppress after low-dose dexamethasone screens for Cushing syndrome.

  • C. GnRH stimulation test

    GnRH stimulation assesses pituitary gonadotropin reserve.

  • D. Cosyntropin stimulation test

    Cosyntropin testing is used to diagnose adrenal insufficiency or non-classic CAH.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, 1 mg overnight dexamethasone suppression test. A morning cortisol above the cut-off after 1 mg of dexamethasone at night fails to suppress and suggests cortisol excess.

Why is "Insulin tolerance test" not the answer?

Insulin tolerance testing assesses cortisol and GH reserve in hypopituitarism.

Why is "GnRH stimulation test" not the answer?

GnRH stimulation assesses pituitary gonadotropin reserve.

Why is "Cosyntropin stimulation test" not the answer?

Cosyntropin testing is used to diagnose adrenal insufficiency or non-classic CAH.

What concept does this question test?

It tests Gynaecological endocrinology: screening for Cushing syndrome in OBG. Late-night salivary cortisol or 24-hour urinary free cortisol are alternatives.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological endocrinology: screening for Cushing syndrome?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.