Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is a characteristic feature of primary adrenal insufficiency?

1. Hypernatremia

2. Hypotension

3. Hypoglycemia

4. Hypokalemia

The correct answer is: Hypotension

Primary adrenal insufficiency, also known as Addison's disease, is characterized by the inadequate production of adrenal hormones, particularly cortisol and often aldosterone, due to damage to the adrenal glands. One prominent feature of this condition is hypotension, or low blood pressure. This occurs because cortisol plays a critical role in maintaining vascular tone and regulating blood pressure. When cortisol levels are insufficient, patients often experience a significant drop in blood pressure, which can lead to symptoms like dizziness or fainting, especially when standing up. Additionally, decreased aldosterone leads to the loss of sodium and water, compounding the hypotensive effects. While other options like hypernatremia, hypoglycemia, and hypokalemia may occur under certain conditions or treatments, they are not characteristic features of primary adrenal insufficiency. In fact, patients with primary adrenal insufficiency typically present with hyponatremia (low sodium levels) and hyperkalemia (high potassium levels) due to the lack of aldosterone, further emphasizing why hypotension is the defining characteristic of this condition.