question: Q:A 7-year-old boy is rushed to the emergency room after developing severe abdominal pain with nausea and vomiting for a day at a summer camp. He also has a bad cough and generalized muscle weakness. He was doing fine until these symptoms started on day 3 of his camp. Past medical history obtained from his parents on the phone was significant for recurrent nephrotic syndrome controlled by prolonged corticosteroid therapy. His blood pressure is 110/75 mm Hg, axillary temperature is 38.9°C (102.0°F) and random blood sugar is 49 mg/dL. On examination, he appears somnolent. His heart has a regular rate and rhythm and his lungs have rhonchi and focal wheezing, bilaterally. Results of other lab investigations are:
  Sodium 131 mEq/L
  Potassium 5.1 mEq/L
  Chloride 94 mEq/L
  Bicarbonate 16 mEq/L
  Urea 44 mg/dL
  Creatinine 1.4 mg/dL
  A respiratory culture is positive for type A influenza. Which of the following is most likely to be the predisposing cause of the patient’s symptoms?? 
  {'A': 'Bilateral hemorrhagic necrosis of the adrenal glands', 'B': 'Iatrogenic suppression of a trophic effect on the adrenal glands', 'C': 'An extremely virulent form of Influenza', 'D': 'Immunosuppression', 'E': 'Primary adrenal insufficiency'},