system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 28-year-old lady has put on weight (10 kg over a period of 3 years) and has oligomenorrhoea followed by amenorrhoea for 8 months. The blood pressure is 160/100 mm of Hg. Which of the following is the most appropriate investigation?
assistant
The correct answer is  Weight gain + Oligomenorrhea --->Cushing syndrome. Coisol inhibits gonadotropin release that explains the amenorrhea. Hypeension in these patients is secondary to increased coisol that has some mineralocoicoid activity also. Excess glucocoicoids also interfere with central regulatory systems, leading to suppression of gonadotropins with subsequent hypogonadism and amenorrhea, and suppression of the hypothalamic pituitary-thyroid axis, resulting in decreased TSH (thyroid-stimulating hormone) secretion. Weight gain + menorrhagia + isolated diastolic hypeension in the question would have prompted thyroid dysfunction as the first answer.