Primary adrenal insufficiency — MCCQE Part 1 MCQ

Correct answer: D — Primary adrenal insufficiency

Primary adrenal insufficiency is the single best answer because the age, timing, examination findings and investigations in the vignette fit Primary adrenal insufficiency better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Endocrine Society and Canadian endocrinology guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Endocrine Society and Canadian endocrinology guidance