A woman with autoimmune adrenal insufficiency has vomiting, hypotension, sodium 121 mmol/L, potassium 6.0 mmol/L and glucose 3.0 mmol/L. Intravenous

Question

A woman with autoimmune adrenal insufficiency has vomiting, hypotension, sodium 121 mmol/L, potassium 6.0 mmol/L and glucose 3.0 mmol/L. Intravenous access is delayed. Which immediate glucocorticoid plan is correct while isotonic fluid and glucose are arranged?

Accepted Answer

Hydrocortisone 100 mg intramuscularly now, then 200 mg over each 24 hours

Answer

Dexamethasone 0.5 mg orally now, then restart her usual replacement tomorrow

Answer

Fludrocortisone 100 micrograms orally now as the only steroid treatment

Answer

Prednisolone 5 mg orally now, repeated only if the cortisol result is low

Answer

Hydrocortisone 20 mg intramuscularly now, then 10 mg every 6 hours

Myxoedema coma with hyponatraemia — SCE Acute Medicine MCQ

A woman with autoimmune adrenal insufficiency has vomiting, hypotension, sodium 121 mmol/L, potassium 6.0 mmol/L and glucose 3.0 mmol/L. Intravenous access is delayed. Which immediate glucocorticoid plan is correct while isotonic fluid and glucose are arranged?