Diabetes Mellitus USMLE Step 1 Practice Question
A 59-year-old woman with rheumatoid arthritis abruptly discontinued prednisone 5 days ago. She presents with fatigue, nausea, diffuse myalgias, and dizziness. Vital signs show BP 92/58 mmHg, HR 102 bpm, RR 18/min, temperature 37.2°C. Labs reveal morning cortisol 3 mcg/dL (low), ACTH 8 pg/mL (low), sodium 131 mEq/L, potassium 4.0 mEq/L. Glucose is 92 mg/dL. Which underlying mechanism best explains her presentation?
Answer choices
- ASuppression of the hypothalamic pituitary adrenal axis by chronic glucocorticoid therapyCorrect answer
- BAdrenal hemorrhage due to meningococcemia
- CAutoimmune destruction of the adrenal cortex
- DACTH secreting pituitary adenoma
- EAldosterone secreting adrenal adenoma
- FAcute adrenal insufficiency secondary to tuberculosis of the adrenal glands
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