system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 23-year-old woman from Texas is transferred to the intensive care unit after delivering a child at 40 weeks gestation. The pregnancy was not complicated, and there was some blood loss during the delivery. The patient was transferred for severe hypotension refractory to IV fluids and vasopressors. She is currently on norepinephrine and vasopressin with a mean arterial pressure of 67 mmHg. Her past medical history is notable only for a recent bout of asthma treated with albuterol and a prednisone taper over 5 days for contact dermatitis. Physical exam is notable for abnormally dark skin for a Caucasian woman. The patient states she feels extremely weak. However, she did experience breastmilk letdown and was able to breastfeed her infant. Laboratory values are ordered as seen below.

Serum:
Na+: 127 mEq/L
Cl-: 92 mEq/L
K+: 6.1 mEq/L
HCO3-: 22 mEq/L
BUN: 20 mg/dL
Creatinine: 1.1 mg/dL
Ca2+: 10.2 mg/dL

Which of the following is the most likely diagnosis?
assistant
Primary adrenal insufficiency