A 43-year-old male high-level executive presents to his physician due to a persistent dizziness when standing quickly. He also has been exhibiting chronic fatigue, some muscle weakness, and an unusual craving for salty foods. The physician notices that the patient has a constant "bronze tan," and blood obtained during the visit demonstrated not only normal cholesterol levels but also hypoglycemia, hyperkalemia, and hyponatremia. The underlying cause for these problems is which one of the following?
The patient is exhibiting the symptoms of Addison disease, initiated by an adrenal insufficiency. Owing to the problem in the adrenal glands, cortisol and aldosterone cannot be produced and released. The lack of cortisol leads to hypoglycemia and fatigue. The lack of aldosterone leads to the alteration in salt balance in the blood and the craving for salt. The hyperpigmentation occurs because of excessive ACTH production, which gives rise to the MSH. The ACTH levels are high because of reduced repression of ACTH synthesis, which is caused by the lack of cortisol release from the adrenal cortex. A reduction of insulin levels would lead to diabetes, not the constellation of symptoms observed in this patient. A lack of GH (in the adult) would lead to increased body fat, high cholesterol, and reduced bone density. A lack of glucagon would lead to hypoglycemia, but not the other symptoms observed in this patient.
Adrenal insufficiency
Pituitary insufficiency
Lack of insulin
Lack of glucagon
Endocrinology