A 30-year-old woman presents with fatigue, weight loss, hyperpigmentation and postural dizziness. Blood pressure is 90/60 mmHg supine, 70/50 standing....

Question

A 30-year-old woman presents with fatigue, weight loss, hyperpigmentation and postural dizziness. Blood pressure is 90/60 mmHg supine, 70/50 standing. Serum sodium is 130 mmol/L, potassium 5.8 mmol/L. Which is the most appropriate initial treatment for suspected Addison disease with adrenal crisis features?

Accepted Answer

Immediate IV hydrocortisone and volume resuscitation with isotonic saline

Answer

Start high-dose dexamethasone only after ACTH stimulation test

Answer

Start fludrocortisone only

Answer

Start beta blocker to manage hypotension

Answer

Delay any steroids until endocrine consultation

ca-mccqe1 MCQ (SBA): Adrenal crisis initial management