A 40-year-old man has an increasing weakness, fatigue, weight loss and abdominal pain for 5 months. He appears thin, his BP is 90/55 mmHg lying and 85/40 standing. He has hyperpigmentation gums and palmer creases What is the single best diagnosis?
سؤال مجاني 6 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Primary adrenal insufficiency
Weakness, weight loss, abdominal pain and postural hypotension point to adrenal insufficiency, and hyperpigmentation of gums and palmar creases (from high ACTH/MSH) occurs only in primary adrenal insufficiency (Addison disease). Secondary AI and panhypopituitarism have low ACTH, so there is no hyperpigmentation.
ليش كل خيار صح أو غلط
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A
ليش غلط
CAH is a congenital enzyme defect (21-hydroxylase in 90%): females have ambiguous genitalia and males risk a salt-wasting crisis; it is not new weakness and weight loss at age 40.
✓ Adrenal gland disorders.pdf · p. 1 -
B
ليش صح
Hyperpigmentation (gums, palmar creases) is common in primary adrenal insufficiency because low cortisol drives ACTH and MSH up; it is not seen in secondary or tertiary AI.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10 -
C
ليش غلط
Pituitary failure is a secondary cause of adrenal insufficiency, whereas skin pigmentation is listed as a feature of primary disease.
✓ Adrenal gland disorders.pdf · p. 1 -
D
ليش غلط
In secondary AI ACTH is low, not high, so there is no MSH-driven hyperpigmentation; his pigmented gums and palmar creases point to primary disease.
✓ Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10
- المصدر
- Step Up To Medicine 6th Edition 2024 (Adrenal).pdf · p. 10
- المحاضرة
- Adrenal Insufficiency · Endocrinology · Module B
- ظهر في
- Endo bank