Cushing syndrome is characterized by which of the following clinical manifestations?

Cushing syndrome is primarily caused by excessive levels of cortisol in the body, which leads to a distinctive set of clinical manifestations. One of the hallmark features is truncal obesity, where there is an abnormal accumulation of fat in the abdomen and upper back, leading to a rounded face (often referred to as a "moon face") and a pronounced neck (sometimes called "buffalo hump").

In addition to truncal obesity, individuals with Cushing syndrome often experience hypertension due to cortisol's effects on increasing blood volume and vascular reactivity, as well as its impact on sodium retention. This connection between cortisol and increased blood pressure is a crucial consideration in the diagnosis and management of this condition.

The other options present clinical features that do not align with Cushing syndrome. Weight loss and hyponatremia are more associated with conditions like adrenal insufficiency. An adrenal crisis and hyperpigmentation relate more to Addison’s disease, characterized by low cortisol levels. Hypoglycemia can be seen in various contexts, including adrenal insufficiency, but is contradictory to typical findings in Cushing syndrome, which often presents with hyperglycemia. Hirsutism can occur but is not a primary defining feature of Cushing syndrome compared to truncal obesity and hypertension.