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General Medicine · Endocrinology: primary adrenal insufficiency
Sample itemA patient has fatigue, weight loss, postural dizziness, hyperpigmentation, hyponatremia, and hyperkalemia. Which diagnosis best fits?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Primary adrenal insufficiency
Primary adrenal insufficiency causes low cortisol and aldosterone with compensatory ACTH elevation, explaining hyperpigmentation, hypotension, hyponatremia, and hyperkalemia. It can present as an adrenal crisis during physiological stress.
Option by option
A. Primary hyperaldosteronism
Primary hyperaldosteronism causes hypertension and hypokalemia.
B. Pheochromocytoma
Pheochromocytoma causes episodic catecholamine symptoms, often with hypertension.
C. Cushing syndrome
Cushing syndrome causes cortisol excess with features such as proximal weakness and glucose intolerance.
D. Primary adrenal insufficiency (correct)
Correct. The electrolyte pattern and ACTH-related hyperpigmentation are characteristic.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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