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Question 1 of 25
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Why do patients with secondary adrenal insufficiency caused by long-term oral prednisolone usually not develop the hyperkalaemia and skin pigmentation seen in Addison disease?
Pigmentation and hyperkalaemia only appear after 10 years of adrenal failure
Renin-angiotensin control of aldosterone is intact, and ACTH is low
The adrenal medulla takes over cortisol production in secondary disease
Prednisolone itself has strong mineralocorticoid activity that replaces aldosterone completely
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