This page is dedicated to organizing various examples of standardized exam questions whose answer is corticoadrenal insufficiency (Addison disease). While this may seem a odd practice, it is useful to see multiple examples of how Addison disease will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each condition has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for Addison disease.
- Decreased energy/fatigue can be the chief complaint of the patient
- Hypotension will be reported (if vitals are taken)
- Hyperpigmentation of the skin/gums might be noted
- Hyponatremia + hyperkalemia is the classic finding on the electrolytes that will be reported.
Question # 1
An 80 year old man comes to the clinic with complaints of decreased energy. He explains that he has lost 5 lbs in the last 2 months because he has had a decreased appetite. The patient’s BMI is 22 mg/m2, and he appears mildly emaciated. His temperate is 98.5°F, heart rate is 70/min, and blood pressure is 90/50 mm Hg. The rest of the physical exam is unremarkable. Labs are collected and listed below:
- Hemoglobin: 14.0 g/dL
- Leukocyte count: 7,000/mm3
- Serum sodium: 127 mEq/L ***
- Serum potassium: 6.1 mEq/L ***
- Creatinine: 1.7 mg/dL
What could this patient’s diagnosis be?
Explanation: low energy + hypotension + hyponatremia + hyperkalemia = Addison disease (ACTH stimulation test will help confirm diagnosis)
A 8 year old girl is brought to the clinic after fainting while on a field trip with her class. Her parents explain that she has become progressively more fatigued over the past winter, and they had noticed that her skin has darkened. Her height and weight are both in the 55th percentile. Her blood pressure is 80/40 mm Hg. What condition could explain this patient’s presentation?
Explanation: fatigue + skin hyperpigmentation + low blood pressure = Addison disease
Page Updated: 01.22.2017