Professional and Linguistic Assessments Board (PLAB) Practice Exam

Where does secondary adrenal insufficiency primarily originate?

1. Adrenal glands

2. Pituitary gland

3. Hypothalamus

4. Thyroid gland

The correct answer is: Pituitary gland

Secondary adrenal insufficiency primarily originates from the pituitary gland. This condition occurs when there is inadequate secretion of adrenocorticotropic hormone (ACTH) from the pituitary gland, which is responsible for stimulating the adrenal glands to produce cortisol. In cases of secondary adrenal insufficiency, the adrenal glands themselves are usually normal and capable of producing cortisol, but they do not do so adequately due to low levels of ACTH from the pituitary. Understanding that the issue lies at the level of the pituitary helps in diagnosing and managing the condition. Treatment often involves addressing the underlying cause of the pituitary dysfunction, which could include conditions such as pituitary tumors, trauma, or other diseases that affect pituitary function. In contrast, primary adrenal insufficiency is related to problems in the adrenal glands themselves, while the hypothalamus can influence the pituitary gland but is not the primary source of the insufficient hormone in this scenario. The thyroid gland does not play a role in adrenal hormone production, further clarifying the focus on the pituitary gland as the origin of secondary adrenal insufficiency.