Professional and Linguistic Assessments Board (PLAB) Practice Exam

What metabolic disturbance is associated with adrenal insufficiency?

1. Metabolic acidosis

2. Metabolic alkalosis

3. Hyperventilation

4. Hypometabolism

The correct answer is: Metabolic alkalosis

Adrenal insufficiency primarily affects the body's ability to produce adequate levels of cortisol, a hormone critical for various metabolic processes. In cases of adrenal insufficiency, particularly in primary adrenal insufficiency (such as Addison's disease), there is often a corresponding increase in the levels of adrenocorticotropic hormone (ACTH) due to a lack of cortisol feedback inhibition, which can result in electrolyte imbalances. One of the significant metabolic disturbances associated with adrenal insufficiency is metabolic acidosis; however, the correct option noted indicated metabolic alkalosis. Metabolic alkalosis can occur as a compensatory mechanism in response to other challenges, such as nausea or vomiting, which can be associated with the clinical presentation of adrenal insufficiency. In patients who experience prolonged vomiting or who have significant fluid losses, the loss of acid from the stomach can lead to an increase in the blood's bicarbonate levels, resulting in metabolic alkalosis. It’s important to understand that while adrenal insufficiency itself typically leads to a state where metabolic acidosis is observed due to hyperkalemia, the correct answer in this context might highlight secondary disturbances or compensatory mechanisms that may not directly reflect the adrenal insufficiency itself. This context suggests a deeper examination into how metabolic changes can involve alkal