Question

A female patient presents to her primary

care doctor with thinning scalp hair, excessive
facial hair, and high ACTH and low cortisol levels
in her blood. The physician should seriously
consider which one of the following problems?
(A) A tumor of the anterior pituitary that
produces abnormally large amounts of
POMC.
(B) A tumor of the adrenal medulla that secretes
abnormally large amounts of its
normal hormone product.
(C) A genetic deficiency of an enzyme in the
pathway for cortisol synthesis.
(D) A mutation in the gene for CRH that decreases
the production of this polypeptide.
(E) An insulinoma.

Answer 1

The female patient with hair changes, high ACTH, and low cortisol likely has a genetic deficiency of an enzyme in cortisol synthesis, indicative of adrenal insufficiency or Addison's disease.

Step-by-step explanation:

The patient presenting with thinning scalp hair, excessive facial hair, high levels of ACTH, and low cortisol levels may be experiencing a primary adrenal insufficiency, also known as Addison's disease. This condition is characterized by inadequate production of cortisol due to an issue with the adrenal glands themselves or due to a lack of ACTH stimulation from the pituitary gland. The correct response, given the symptoms, would be (C) A genetic deficiency of an enzyme in the pathway for cortisol synthesis. This scenario suggests that the adrenal glands aren't able to produce cortisol even though the pituitary is releasing plenty of ACTH (which is signaled by the high ACTH levels).