A 52-year-old man with a history of tuberculosis presents with fatigue and weight loss. His morning cortisol is 2 μg/dL and ACTH is 180 pg/mL. He does not have skin hyperpigmentation. Chest X-ray shows evidence of old granulomatous disease. Which test will best establish the etiology of his adrenal insufficiency?

  1. A)Plasma renin activity and aldosterone level
  2. B)ACTH stimulation test with cosyntropin
  3. C)Adrenal CT imaging to assess gland size and calcificationGABARITO
  4. D)Serum cortisol response to dexamethasone suppression
  5. E)Thyroid function tests

Explicação

Tuberculosis is a common cause of primary adrenal insufficiency, particularly in endemic regions. Adrenal CT will show bilateral gland enlargement, destruction, and/or calcification characteristic of TB-induced adrenalitis, helping confirm the infectious etiol... Ver explicação completa e trilha adaptativa →

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