<prompt> Answer this question truthfullyIn a chronic smoker who develops hypertension, hyperglycemia, and weight gain, what is the likely diagnosis?  <response>: <reason> The likely diagnosis is Cushings syndrome, which is a condition that occurs when the body is exposed to high levels of the hormone cortisol for an extended period of time. In chronic smokers, Cushings syndrome is often caused by an ectopic production of adrenocorticotropic hormone ACTH due to small cell lung carcinoma. Symptoms of Cushings syndrome may include hypertension high blood pressure, hyperglycemia high blood sugar, weight gain, muscle weakness, and mood changes. Treatment for Cushings syndrome may involve addressing the underlying cause, such as with surgery, chemotherapy, or radiation therapy for cancer, as well as medications to lower cortisol levels, such as ketoconazole or metyrapone. 