🏥 USMLE Exam Prep

A 45-year-old woman presents with chronic fatigue, weight loss, nausea, and diffuse skin hyperpigmentation, especially in sun-exposed areas and palmar creases. Laboratory tests show low serum cortisol and high ACTH. Which of the following is the most appropriate initial treatment?

A Levothyroxine
B Hydrocortisone
C Metformin
D Spironolactone

✓ Correct Answer: Option B

This patient presents with classic symptoms and lab findings of primary adrenal insufficiency (Addison's disease). The most appropriate initial treatment is glucocorticoid replacement, typically with hydrocortisone.

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