Pathology · single question
ADDISON'S DISEASE CASE: A female patient presents with lethargy, blood pressure of 80/60 mmHg, and bronze hyperpigmentation of the skin. What is the most likely diagnosis?
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Correct answer: C. Addison's Disease (primary adrenal insufficiency)
Addison's Disease (primary adrenal insufficiency) results from destruction of the adrenal cortex, causing deficiency of cortisol and aldosterone. Classic presentation: fatigue/lethargy, hypotension (orthostatic or frank shock), hyponatremia/hyperkalemia, and BRONZE HYPERPIGMENTATION (due to elevated ACTH stimulating melanocortin receptors). Oral mucosal pigmentation is also characteristic.
- A. CORRECT. The triad of hypotension + lethargy + bronze pigmentation is classic for Addison's Disease (primary adrenal insufficiency with elevated ACTH).
- B. Incorrect. Cushing's Syndrome features HYPERTENSION, moon face, central obesity, striae, and buffalo hump — the opposite of hypotension.
- C. Incorrect. Hypothyroidism presents with fatigue, weight gain, cold intolerance, bradycardia, and dry skin/hair — not bronze pigmentation or hypotension.
- D. Incorrect. Pheochromocytoma causes episodic severe HYPERTENSION with headache, sweating, and tachycardia — not hypotension or pigmentation.