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: Pathology
A 17 year old female patient has hirsutism, hyperglycemia, obesity, muscle wasting, and increased circulating levels of ACTH. The most likely cause of her symptoms is: 
Select and explain. 
A. Primary adrenocoical insufficiency, B. Primary overproduction of ACTH, C. Exogenous steroids, D. Hypophysectomy
B: Primary overproduction of ACTH
Answer: B: Primary overproduction of ACTH 
Explanation: This female patient's symptoms are classic for a primary elevation of ACTH (Cushing's Disease). Exogenous steroids would produce similar symptoms, except that circulating ACTH would be low because of negative feedback suppression at both hypothalamic (CRF) and anterior pituitary levels (ACTH). Addison's Disease is caused by glucocoicoid deficiency, not excess. Hypophysectomy would lead to a decrease in ACTH or remove the source of it.