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Adrenal Crisis Management — NDEB AFK MCQ

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HardMedical Emergencies in DentistryAdrenal Crisis ManagementNDEB AFK

What is the appropriate management of a patient who presents with an acute adrenal crisis (Addisonian crisis) in the dental office?

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Correct answer: A — Administer hydrocortisone 100 mg IV or IM, position supine, IV fluids, and activate EMS

Acute adrenal crisis presents with severe hypotension, tachycardia, weakness, confusion, nausea, vomiting, and potential cardiovascular collapse. It occurs in patients with adrenal insufficiency (on chronic corticosteroids, Addison disease) under physiological stress. Treatment: hydrocortisone 100 mg IV or IM (or dexamethasone 4 mg IV if hydrocortisone unavailable), position supine with legs elevated, IV fluids (normal saline), oxygen, and activate EMS. Prevention: supplemental corticosteroids before stressful dental procedures in at-risk patients.

Reference: Malamed – Medical Emergencies in the Dental Office, 8th ed., 2022