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Adrenal crisis prevention — GPhC CRA MCQ

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HardEndocrine TherapeuticsAdrenal crisis preventionGPhC CRA

A patient with Addison disease is repeatedly vomiting, cannot retain oral hydrocortisone and is becoming drowsy and hypotensive. Their partner has an in-date emergency hydrocortisone kit. What should be done?

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

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Correct answer: B — Give hydrocortisone 100 mg intramuscularly now and call emergency services

Option B follows NICE emergency management: suspected adrenal crisis is treated immediately with 100 mg IM or IV hydrocortisone while urgent medical help is obtained. Option E risks deterioration because oral absorption is failing. Option C does not provide adequate glucocorticoid rescue. Option D underdoses and delays transfer. Option A uses a route outside the recommended IM or IV emergency regimen and understates the need for emergency transfer.

Reference: NICE NG243: https://www.nice.org.uk/guidance/NG243/chapter/recommendations