skip to main content

Adrenal Crisis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyEndocrinologyAdrenal CrisisRACP Adult Medicine

A 30-year-old woman with Addison disease on hydrocortisone and fludrocortisone presents with vomiting, diarrhoea, and fever (39.2°C). BP is 85/55 mmHg, heart rate 125 bpm. She has been unable to take oral medications. What is the most appropriate immediate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — IV hydrocortisone 100 mg bolus then 50 mg 6-hourly

Adrenal crisis requires immediate IV hydrocortisone 100 mg bolus followed by 50 mg every 6–8 hours. IV normal saline resuscitation should be given concurrently. Hydrocortisone at these doses provides sufficient mineralocorticoid activity, so separate fludrocortisone is not needed acutely. Never delay treatment for investigations.

Reference: Society for Endocrinology – 2020 – Adrenal Crisis Guidelines; eTG Endocrine 2024