question: Q:A 48-year-old woman presents to her primary care physician with the complaints of persistent fatigue, dizziness, and weight loss for the past 3 months. She has hypothyroidism for 15 years and takes thyroxine replacement. Her blood pressure is 90/60 mm Hg in a supine position and 65/40 mm Hg while sitting, temperature is 36.8°C (98.2°F) and pulse is 75/min. On physical examination, there is a mild increase in thyroid size, with a rubbery consistency. Her skin shows diffuse hyperpigmentation, more pronounced in the oral mucosa and palmar creases. The morning serum cortisol test is found to be 3 µg/dL. Which of the following is the best next step in this case?? 
  {'A': 'Serum adrenocorticotropic hormone (ACTH)', 'B': 'Plasma aldosterone', 'C': 'Adrenocorticotropic hormone (ACTH) stimulation test', 'D': 'Adrenal imaging', 'E': '21-hydroxylase antibodies'},