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Medical Emergencies · single question

A 53-year-old woman feels chronically tired, appears unwell, takes no medications, and has noticeable skin hyperpigmentation. She needs an extraction. Which condition do these findings suggest?

  1. Hyperthyroidism (Graves' disease)
  2. Addison's disease (primary adrenal insufficiency)
  3. Iron-deficiency anemia
  4. Cushing's syndrome
Show answer and explanation

Correct answer: B. Addison's disease (primary adrenal insufficiency)

  • A. Hyperthyroidism causes weight loss, heat intolerance, and tachycardia, not characteristic skin bronzing.
  • B. Correct. Fatigue, weakness, looking unwell, and diffuse skin (and mucosal) HYPERPIGMENTATION are classic for Addison's disease. In primary adrenal insufficiency, low cortisol drives up ACTH/MSH precursor (POMC), which stimulates melanocytes and bronzes the skin.
  • C. Iron-deficiency anemia causes fatigue and PALLOR, not hyperpigmentation.
  • D. Cushing's (cortisol EXCESS) causes weight gain, moon face, and striae — not the hyperpigmentation-plus-fatigue picture of cortisol deficiency.

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