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ASD – speech pathology — RACP Paediatrics MCQ

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

HardNeurologyASD – speech pathologyRACP Paediatrics

A 6-year-old with panhypopituitarism presents after gastroenteritis with lethargy, glucose 2.1 mmol/L, sodium 128 mmol/L and shock. His family could not retain oral hydrocortisone. Which immediate treatment is most important alongside resuscitation?

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

Reveal the answer and explanation

Correct answer: C — Give hydrocortisone 50 mg intravenously during initial resuscitation

Explanation lettering: E = shown as A · C = shown as B · A = shown as C · B = shown as E

A is correct. A 6-year-old with secondary adrenal insufficiency and shock requires immediate stress-dose hydrocortisone 50 mg IM/IV, isotonic fluid and glucose correction. B is inadequate and cannot be absorbed reliably. C secondary adrenal insufficiency usually retains aldosterone, and stress hydrocortisone plus fluids is the acute priority. D does not resuscitate adrenal shock. E thyroid hormone before cortisol replacement can worsen adrenal crisis.

Reference: RCH Melbourne, Adrenal crisis and acute adrenal insufficiency: https://www.rch.org.au/clinicalguide/guideline_index/Adrenal_crisis_and_acute_adrenal_insufficiency/