This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'All of the following statements about acute adrenal insufficiency are true, EXCEPT: \nSelect and explain. \nA. Hyperglycemia is usually present, B. Acute adrenal insufficiency usually is secondary to exogenous glucocoicoid administration, C. Acute adrenal insufficiency presents with weakness, vomiting, fever, and hypotension, D. Hyponatremia occurs because of impaired renal tubule sodium resorption', 'role': 'user'}, {'content': "Answer: A \nExplanation: Adrenal insufficiency is associated with decreased levels of glucocoicoids, mineralocoicoids and androgens. Normally coisol is involved in hepatic glycogen synthesis, gluconeogenesis and release of glucose into the circulation. So in adrenal insufficiency, deficiency of coisol results in hypoglycemia. Adrenal insufficiency can be primary (resulting from adrenal disease), or secondary (due to a deficiency of ACTH). Primary adrenal insufficiency can be caused by autoimmune disease, infections, and metastatic deposits. Most common cause of secondary adrenal insufficiency is therapy with exogenous glucocoicoids. Ref: Schwaz's Principles of Surgery, 9th Edition, Chapter 38; Modern Nutrition In Health And Disease By Maurice Edward Shils, 10th Edition, Page 646; Davidson's Principles and Practice of Medicine, 21st Edition, Page 775, Box: 20.45", 'role': 'assistant'}]