A 60-Year-Old Woman Is Being Evaluated for Chronic Weakness and Fatigue

A 60-year-old woman is being evaluated for chronic weakness and fatigue.  She has no other medical problems and takes no medications.  After performing initial laboratory studies, the physician decides to proceed with a metyrapone stimulation test.  The changes in urinary 17-hydroxycorticosteroid (17-OHS) excretion following metyrapone administration are shown in the graph below. Which of the following mechanisms is most likely responsible for the findings seen in the graph?

A) ACTH surge
B) Aldosterone overproduction
C) Cortisol overproduction
D) Renin surge
E) Vasopressin overproduction

Correct Answer:

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