Sudden withdrawal of long-term corticosteroid therapy can lead to life-threatening acute adrenal insufficiency primarily because:
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Correct answer: Exogenous steroids cause atrophy of the adrenal cortex via HPA axis suppression
Chronic corticosteroid use suppresses the secretion of CRH and ACTH through negative feedback. This leads to atrophy of the adrenal glands, which cannot immediately produce endogenous cortisol if the medication is stopped abruptly.
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