You are caring for an unconscious patient.  Family states th…

You are caring for an unconscious patient.  Family states that she has been complaining of weakness, lethargy, nausea and vomiting over the last several days.  Family denies a history of diabetes, however, her CBG is found to be 55.  Heart rate 80. You also see peaked T waves and flattened P waves on the cardiac monitor.  You note hyper pigmentation of the patients oral mucosa and hands.  BP is 90/60, with little response to fluids. The only medication found in the home is Solu-Cortef.  What is the most likely cause of the patient’s condition?