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Adrenal crisis — DipIMC MCQ

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ModerateMedical EmergenciesAdrenal crisisDipIMC

A 58-year-old man with adrenal insufficiency is found vomiting and confused after two days of diarrhoea. Blood pressure is 82/48, glucose is 3.2 mmol/L and he wears a steroid emergency bracelet. What is the most appropriate drug/dose?

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

Reveal the answer and explanation

Correct answer: C — Hydrocortisone 100 mg IM or IV according to available access

Adrenal crisis presents with shock, vomiting, weakness, hypoglycaemia or confusion in a patient at risk, and hydrocortisone should be given promptly. Insulin would worsen hypoglycaemia and shock. Antihistamine does not treat adrenal failure. The pearl is that steroid emergency cards and bracelets are actionable information in pre-hospital care.

Reference: JRCALC Guidelines 2025; Society for Endocrinology Emergency Guidance