Which physical exam finding is likely in an obese woman with fatigue and easy bruisability?

In an obese woman presenting with fatigue and easy bruisability, the physical exam finding of facial plethora is significant. Facial plethora refers to a reddish or purplish discoloration of the face and is often associated with conditions that lead to increased blood flow or changes in blood volume. In the context of obesity, this could indicate the presence of conditions such as Cushing's syndrome, which is characterized by excess cortisol production.

Cushing's syndrome can lead to obesity, fatigue, and easy bruising due to the effects of cortisol on blood vessels and skin. Elevated cortisol levels can increase vascular permeability, leading to easy bruising, and can also manifest as facial plethora due to increased blood flow or changes in skin vasculature.

While other physical findings like hypotension, peripheral edema, and skin thickening can be associated with various conditions, they do not specifically correlate as strongly with the symptom profile of Cushing's syndrome and the presented symptoms of fatigue and easy bruisability in this patient. Thus, facial plethora is the finding that aligns best with the underlying pathology likely present in this scenario.