This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': "Cushing's disease is characterized by \nSelect and explain. \nA. Increased urinary catecholamines, B. Increased serum ACTH and serum coisol, C. Increased serum ADH, D. Decreased serum ACTH and increased serum coisol", 'role': 'user'}, {'content': "Answer: B \nExplanation: Increased serum ACTH and serum coisol * Regardless of etiology all cases of endogenous Cushing's syndrome are due to an increased production of coisol by the adrenal gland. * In most cases, cause is bilateral adrenal hyperplasia due to hypersecretion of pituitary ACTH or ectopic production of ACTH by a nonpituitary source. * The incidence of pituitary-dependent adrenal hyperplasia is three times greater in women than in men. * The primary defect is a pituitary adenoma, as tumor is found in >90% of patients with pituitary-dependent adrenal hyperplasia. * Alternatively, the defect may occasionally reside in the hypothalamus or in higher neural centers, leading to a release of CRH inappropriate to the level of circulating coisol. * This primary defect leads to hyperstimulation of the pituitary, resulting in hyperplasia and tumor formation. * Most individuals with hypersecrete tion of pituitary ACTH are found to have a microadenoma (<10mm) in diameter and macroadenoma (>10 mm). * Traditionally, only an individual who has an ACTH producing pituitary tumor is defined as having Cushing's disease, where Cushing's syndrome refers to all causes of excess coisol: exogenous ACTH tumor, adrenal tumor, pituitary ACTH-secreting tumor, or excessive glucocoicoid treatment.", 'role': 'assistant'}]