A 67 year old man with known Addison’s disease is admitted with vomiting and diarrhoea and is unable to take his usual oral Hydrocortisone. He is hypo...

Question

A 67 year old man with known Addison’s disease is admitted with vomiting and diarrhoea and is unable to take his usual oral Hydrocortisone. He is hypotensive, hyponatraemic and hyperkalaemic. What is the most appropriate immediate management?

Accepted Answer

Give intravenous Hydrocortisone 100 mg stat followed by regular doses and fluids

Answer

Omit steroids until vomiting settles

Answer

Give oral Hydrocortisone as soon as possible

Answer

Give intramuscular Hydrocortisone 25 mg once

Answer

Switch to Fludrocortisone alone

uk-plab-1 MCQ (SBA): Acute adrenal crisis

A 67 year old man with known Addison’s disease is admitted with vomiting and diarrhoea and is unable to take his usual oral Hydrocortisone. He is hypotensive, hyponatraemic and hyperkalaemic. What is the most appropriate immediate management?