What is the Addison's disease presentation and how is it diagnosed?

Cushing's syndrome — diagnosed by elevated 24h urine cortisol
Hypercortisolism — diagnosed by low morning cortisol
Adrenocortical insufficiency — diagnosed by ACTH stimulation test (low cortisol response)
Hyperaldosteronism — diagnosed by elevated aldosterone levels

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Correct answer: C. Adrenocortical insufficiency — diagnosed by ACTH stimulation test (low cortisol response)

A. Cushing's syndrome involves excess cortisol — not Addison's.
B. Hypercortisolism is Cushing's syndrome — the opposite of Addison's.
C. Correct. Addison's disease (primary adrenocortical insufficiency) is caused by destruction of the adrenal cortex. Oral manifestations include bronze mucosal pigmentation. Diagnosis: ACTH (cosyntropin) stimulation test — failure to raise cortisol confirms adrenal insufficiency. Patients are at risk for adrenal crisis under stress.
D. Hyperaldosteronism (Conn's syndrome) is excess aldosterone — causing hypertension and hypokalemia.

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