A patient with primary adrenal insufficiency is febrile at 39.2°C with influenza but is drinking, not vomiting and haemodynamically stable. Their

Question

A patient with primary adrenal insufficiency is febrile at 39.2°C with influenza but is drinking, not vomiting and haemodynamically stable. Their usual hydrocortisone is 10 mg on waking, 5 mg at noon and 5 mg at 17:00. What self-management advice is appropriate during the significant illness?

Accepted Answer

Use sick-day glucocorticoid dosing throughout the febrile illness

Answer

Pause hydrocortisone during fever to support infection clearance

Answer

Continue usual glucocorticoid dosing while oral absorption persists

Answer

Use intramuscular hydrocortisone while tablets and fluids remain tolerated

Answer

Increase fludrocortisone instead of changing glucocorticoid dosing

VO2max — MRCP Part 1 MCQ

A patient with primary adrenal insufficiency is febrile at 39.2°C with influenza but is drinking, not vomiting and haemodynamically stable. Their usual hydrocortisone is 10 mg on waking, 5 mg at noon and 5 mg at 17:00. What self-management advice is appropriate during the significant illness?