Final answer:
The patient's symptoms suggest Addison's disease, which requires cortisol replacement therapy. The correct treatment includes hydrocortisone for replacing cortisol and fludrocortisone for mineralocorticoid replacement, addressing both glucocorticoid and mineralocorticoid deficiencies.
Step-by-step explanation:
The patient's symptoms and laboratory findings are indicative of Addison's disease, a disorder characterized by adrenal insufficiency due to hyposecretion of cortisol. This condition can be life-threatening and requires immediate medical intervention. The correct treatment in this case would be to provide cortisol replacement therapy to address the cortisol deficiency and manage the symptoms.
Considering the patient's low morning cortisol level, high plasma adrenocorticotropic hormone (ACTH) level, and clinical symptoms, such as orthostatic hypotension and hyperpigmented skin, the appropriate treatment option from the list provided would be:
- Hydrocortisone - This medication serves as a glucocorticoid replacement to compensate for the decreased production of cortisol by the adrenal glands.
Additionally, because patients with Addison's generally have aldosterone deficiency as well, they may also require mineralocorticoid replacement with:
- Fludrocortisone - This helps to maintain adequate blood pressure, blood volume, and sodium and potassium levels, addressing the orthostatic hypotension and electrolyte imbalances.
Therefore, the most appropriate treatment for this patient would likely involve a combination of hydrocortisone and fludrocortisone to replace both glucocorticoids and mineralocorticoids, providing comprehensive management of Addison's disease.