What disease is indicated by a tan appearance, low blood pressure, and low blood sugar?

• A. Hypothyroidism
• B. Cushing's syndrome
• C. Addison's disease
• D. Diabetes mellitus

Answer: (C)

This question tests recognition of primary adrenal insufficiency. When the adrenal cortex isn’t producing enough cortisol and aldosterone, several symptoms come together: hyperpigmentation from excess ACTH (which shares a precursor with melanocyte-stimulating hormone) gives the tan appearance; lack of aldosterone leads to sodium loss and volume depletion, causing low blood pressure; and lack of cortisol reduces gluconeogenesis, which can cause low blood sugar, especially during stress.

Other conditions don’t typically produce this exact trio. Hypothyroidism isn’t associated with tan skin and the blood pressure/glucose pattern described. Cushing’s syndrome features high cortisol with high blood pressure and high blood sugar, not low. Diabetes mellitus centers on hyperglycemia, not low blood sugar with hypotension and tan pigmentation.