A 55-year-old man on long-term prednisolone for polymyalgia develops vomiting, abdominal pain and collapse after stopping steroids abruptly. Blood

Question

A 55-year-old man on long-term prednisolone for polymyalgia develops vomiting, abdominal pain and collapse after stopping steroids abruptly. Blood pressure is 82/46 mmHg and sodium is 124 mmol/L. What is the most appropriate immediate management?

Accepted Answer

Intravenous hydrocortisone 100 mg and rapid 0.9% sodium chloride

Answer

Wait for short synacthen test before treatment

Answer

Intravenous insulin and glucose

Answer

Oral hydrocortisone 5 mg and discharge

Answer

Fluid restriction and demeclocycline

Adrenal crisis — SCE Endocrinology MCQ

A 55-year-old man on long-term prednisolone for polymyalgia develops vomiting, abdominal pain and collapse after stopping steroids abruptly. Blood pressure is 82/46 mmHg and sodium is 124 mmol/L. What is the most appropriate immediate management?