Welcome. My name is Divine. This is episode 577 of the Divine Intervention Podcast. In today's podcast,

we're going to be continuing the rapid review series for the USMaly Step 2, Ski, and Step 3 exams.

This is going to be series 119. Let's begin. So what if they give you a question about a 25-year-old female?

You're told that for the last, you know, three months, you know, she has had a lot of weight gain,

and they describe physical exam findings.

They tell you that her blood pressure is 155 over 95.

And you're told that her current BMI is 32 kilograms per meter squared.

And then you're also told that, you know, she has these appropriate streaks on her lower abdomen.

And then you're asked for the most you know appropriate next and you know

they're giving they give you some labs you notice that a potassium is low you notice that a sodium

is a little bit high or normal and they notice that a bicarb is elevated so what should you be

thinking about here um i would really hope you're saying that divine, this person has a Cushing's syndrome, right?

This person has many of the classic findings.

Like, for example, you notice that this person has, you know, weight gain, right?

Steroids cause a person to gain weight, right?

Really boost your appetite.

If you even think about it, when people have a terminal sickness, many times

they're giving steroids because steroids can improve the appetite. It doesn't improve survival,

but it certainly improves their appetite. And then we see that this person has hypertension

because cortisol has aldosterone-like properties. So if, for example, you take cortisol, cortisol works like aldosterone in a sense.

So it's going to increase sodium and watery absorption in the kidneys.

That can increase a person's blood volume and that can raise your blood pressure.

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