A patient undergoes selective adenomectomy for ACTH-dependent Cushing disease without peri-operative steroidogenesis inhibitors. At 08:00 on

Question

A patient undergoes selective adenomectomy for ACTH-dependent Cushing disease without peri-operative steroidogenesis inhibitors. At 08:00 on postoperative day 2, serum cortisol is 42 nmol/L and she is haemodynamically stable. What is the best interpretation?

Accepted Answer

Early remission with temporary adrenal suppression requiring physiological glucocorticoid replacement

Answer

This is an equivocal result because no postoperative cortisol below 200 nmol/L is interpretable

Answer

This is adrenal crisis and mandates repeated 100-mg hydrocortisone boluses despite stability

Answer

This proves permanent primary adrenal insufficiency requiring lifelong fludrocortisone

Answer

This proves surgical failure because remission requires cortisol to remain within the reference interval

Primary aldosteronism — SCE Endocrinology MCQ

A patient undergoes selective adenomectomy for ACTH-dependent Cushing disease without peri-operative steroidogenesis inhibitors. At 08:00 on postoperative day 2, serum cortisol is 42 nmol/L and she is haemodynamically stable. What is the best interpretation?