Oral medicine and oral cancer: pigmentation in adrenal insufficiency: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Oral medicine and oral cancer: pigmentation in adrenal insufficiency

Sample item

A tired woman has hypotension, weight loss, and brown patches on the buccal mucosa and gingiva along with dark palmar creases. What causes the pigmentation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Raised ACTH with melanocyte-stimulating activity

In Addison disease low cortisol removes negative feedback and pituitary ACTH and related POMC peptides rise. These stimulate melanocytes, giving diffuse pigmentation of skin, palmar creases and oral mucosa.

Option by option

  • A. Raised ACTH with melanocyte-stimulating activity (correct)

    Correct. High ACTH, with melanocyte-stimulating action, drives the pigmentation.

  • B. Excess circulating cortisol

    Cortisol is low, not high, in adrenal insufficiency.

  • C. Aldosterone excess

    Aldosterone is deficient in this condition and does not stimulate melanin.

  • D. Haemosiderin deposition from iron overload

    Haemosiderin pigmentation is seen in haemochromatosis, not here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is A, Raised ACTH with melanocyte-stimulating activity. In Addison disease low cortisol removes negative feedback and pituitary ACTH and related POMC peptides rise.

Why is "Excess circulating cortisol" not the answer?

Cortisol is low, not high, in adrenal insufficiency.

Why is "Aldosterone excess" not the answer?

Aldosterone is deficient in this condition and does not stimulate melanin.

Why is "Haemosiderin deposition from iron overload" not the answer?

Haemosiderin pigmentation is seen in haemochromatosis, not here.

What concept does this question test?

It tests Oral medicine and oral cancer: pigmentation in adrenal insufficiency in Dentistry. These stimulate melanocytes, giving diffuse pigmentation of skin, palmar creases and oral mucosa.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral medicine and oral cancer: pigmentation in adrenal insufficiency?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.