Adrenal Disorders USMLE Step 1 Practice Question
A 57 year old man with rheumatoid arthritis abruptly stops taking long term prednisone because of worsening edema. Two days later he develops weakness, nausea, and dizziness. Blood pressure is 90 over 55 mm Hg. Laboratory studies show low cortisol, low ACTH, normal potassium, and no hyperpigmentation. Which of the following best explains this presentation?
Answer choices
- AAutoimmune destruction of the adrenal cortex
- BSuppression of hypothalamic CRH and pituitary ACTH from chronic glucocorticoid therapyCorrect answer
- CBilateral adrenal hemorrhage
- DAldosterone synthase deficiency
- EPheochromocytoma after beta blocker therapy
- FAutoimmune Addison disease with elevated ACTH and hyperpigmentation
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