Adrenal Disorders USMLE Step 1 Practice Question
A 28-year-old woman with autoimmune thyroiditis presents with progressive fatigue, dizziness, and orthostatic hypotension. Vital signs show BP 92/58 mmHg, HR 102 bpm, RR 18, temperature 37.2°C, SpO2 98% on room air. She denies recent medication changes. Laboratory evaluation reveals 8 AM cortisol 2.8 μg/dL (normal >10), ACTH 185 pg/mL (normal <46), sodium 128 mEq/L, and potassium 5.8 mEq/L. Abdominal imaging is unremarkable. Which of the following is the most likely diagnosis?
Answer choices
- APanhypopituitarism
- BPrimary hypothyroidism
- CSecondary adrenal insufficiency
- DSIADH
- EPrimary adrenal insufficiency (Addison disease)Correct answer
- FAcute adrenalitis due to cytomegalovirus infection
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