Adrenal cortical hyperplasia presents with which features?

• A. Night sweats
• B. Weight gain with central obesity and hypertension
• C. Hypoglycemia
• D. Hypotension

Answer: (B)

Adrenal cortical hyperplasia leads to excess cortisol production, which produces the classic Cushingoid picture. Cortisol drives fat redistribution to the trunk, fluid retention, and increased appetite, resulting in weight gain with central obesity. It also raises blood pressure by enhancing vascular responsiveness and promoting sodium retention. Hyperglycemia and insulin resistance are common due to increased gluconeogenesis, not hypoglycemia. Night sweats are not a distinguishing feature of cortisol excess, and hypotension would suggest cortisol deficiency rather than excess. So central obesity with hypertension best reflects adrenal cortical hyperplasia.