Dexamethasone is a drug used to suppress the secretion of ACTH from the anterior pituitary gland. Two patients with hypersecretion of cortisol are given dexamethasone. Anika's cortisol secretion level falls to normal after the medication, but Bonnie's cortisol secretion remains elevated. Which patient has primary hypercortisolism, also known as Cushing's syndrome? Explain your reasoning.
What will be an ideal response?
Dexamethasone suppresses the pituitary's activity, the secretion of ACTH, which then allowed Anika's level to decline. Since Bonnie's level did not decline, this shows that the hypersecretion is NOT due to ACTH, thus it must be coming from the adrenal gland. This is the definition of a primary hypersecretion?an elevated amount from the last gland in the reflex pathway.
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