A 40-year-old man with known Addison’s disease is admitted with vomiting and diarrhoea. He is hypotensive (BP 82/48 mmHg), drowsy and hypoglycaemic. H...

Question

A 40-year-old man with known Addison’s disease is admitted with vomiting and diarrhoea. He is hypotensive (BP 82/48 mmHg), drowsy and hypoglycaemic. He has not been able to take his usual steroids. What is the most appropriate immediate management?

Accepted Answer

IV 0.9% sodium chloride and IV Hydrocortisone

Answer

Oral Hydrocortisone 20 mg and oral fluids

Answer

Start Fludrocortisone alone

Answer

Give IV insulin and dextrose only

Answer

Delay steroids until cortisol levels are measured

uk-plab-1 MCQ (SBA): Adrenal crisis

A 40-year-old man with known Addison’s disease is admitted with vomiting and diarrhoea. He is hypotensive (BP 82/48 mmHg), drowsy and hypoglycaemic. He has not been able to take his usual steroids. What is the most appropriate immediate management?