Adrenal crisis — DipIMC MCQ

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HardMedical EmergenciesAdrenal crisisDipIMC

A woman with Addison's disease has vomiting, abdominal pain and collapse during a hiking trip. She is hypotensive and carries a steroid card. What is the most appropriate drug/dose?

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Correct answer: D — Hydrocortisone 100 mg IV or IM

Option D is correct because Known adrenal insufficiency with shock and vomiting should receive prompt parenteral hydrocortisone. Option E is less appropriate because that dose is an ALS cardiac-arrest dose and is unsafe for this non-arrest indication; option B is less appropriate because aspirin is useful in ACS but inappropriate for this presentation. Option A is less appropriate because untitrated opioid dosing can cause avoidable hypotension or respiratory depression; option C is less appropriate because steroids have delayed onset and should not replace the immediate treatment. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: JRCALC Guidelines; Society for Endocrinology emergency guidance