<s>[INST] context: - Coisol is normally produced by the adrenal glands, located just above the kidneys. - It belongs to a class of hormones called glucocoicoids, which affect almost every organ and tissue in the body. Helps maintain blood pressure and cardiovascular function; Helps slow the immune systems inflammatory response; Helps balance the effects of insulin in breaking down sugar for energy; and Helps regulate the metabolism of proteins, carbohydrates, and fats. - So, afterB/L adrenalectomy coisol production decreaseswhich causes these symptoms: Chronic, worsening fatigue and muscle weakness, loss of appetite, and weight loss are characteristic of the disease. Nausea, vomiting, and diarrhoea occur in about 50 percent of cases. Blood pressure is low and falls fuher when standing, causing dizziness or fainting. Skin changes also occur with areas of hyperpigmentation, or dark tanning, covering exposed and nonexposed pas of the body. This darkening of the skin is most visible on scars; skin folds; pressure points such as the elbows, knees, knuckles, and lips; and mucous membranes. [/INST] question: A patient undergoes bilateral adrenalectomy in view of bilateral pheochromocytoma. A day after surgery patient develops lethargy, fatigue and loss of appetite. On examination BP is 90/ 60 mmHg, pulse rate of 74 beats/min. No evidence of loss of volume. The likely cause is? | options: A: Cardiogenic shock B: Hypovolemic shock C: Coisol deficiency D: Septic shock | answer: C </s>