A 42-year-old man with known Addison's disease presents with vomiting, abdominal pain and collapse after influenza-like illness. Blood pressure is

Question

A 42-year-old man with known Addison's disease presents with vomiting, abdominal pain and collapse after influenza-like illness. Blood pressure is 78/44 mmHg, sodium 126 mmol/L, potassium 5.9 mmol/L and glucose 3.4 mmol/L. What is the most important immediate action?

Accepted Answer

Give intramuscular or intravenous hydrocortisone immediately

Answer

Give fludrocortisone as sole emergency therapy

Answer

Treat with insulin-glucose for presumed primary hyperkalaemia

Answer

Wait for a 9 am cortisol before treatment

Answer

Start oral prednisolone after tolerating food

Adrenal crisis — SCE Acute Medicine MCQ

A 42-year-old man with known Addison's disease presents with vomiting, abdominal pain and collapse after influenza-like illness. Blood pressure is 78/44 mmHg, sodium 126 mmol/L, potassium 5.9 mmol/L and glucose 3.4 mmol/L. What is the most important immediate action?